A recent study entitled “Therapeutic decision in chronic osteomyelitis: sinus track culture versus intraoperative bone culture” presented in the Journal Archives of Orthopaedic and Trauma Surgery suggests that intraoperative bone cultures are still the best way to isolate organisms in cases of chronic osteomyelitis.
A prospective comparative study of chronic osteomyelitis patients seen in our centre from January 2004 to December 2006. Specimens from the depths of sinus track and intraoperative bone biopsy were obtained from each patient and subjected to microbiologic examination and their concordance determined.
Results revealed that in STCs, Staphylococcus aureus has the highest sensitivity (60.5%), specificity (45.0%) and positive predictive value (72.2%). The overall sensitivity (50.9%), specificity (20%) and predictive value (47.5%) of sinus track specimens were very low. Antibiotic decision based on IBC showed 106 patients (82.8%) had resolution of chronic osteomyelitis at mean of 2 years follow-up.
Conclusion IBC appears to predict more reliably the complete etiologic organisms than STCs in chronic osteomyelitis.
