Chronic
osteomyelitis is a challenging setback to the orthopedic surgeons in deciding an optimal therapeutic strategy. Conversely, patients feel frustrated of the therapeutic outcomes and development of adverse
drug effects, if any. Present investigation deals with extensive approach incorporating in vivo animal experimentation and human application to treat chronic
osteomyelitis, using
antibiotic loaded porous
hydroxyapatite scaffolds. Micro- to macro-porous
hydroxyapatite scaffolds impregnated with
antibiotic ceftriaxone-
sulbactam sodium (CFS) were fabricated and subsequently evaluated by in vivo animal model after developing
osteomyelitis in rabbit tibia. Finally 10 nos. of human
osteomyelitis patients involving long bone and mandible were studied for histopathology, radiology,
pus culture, 3D CT etc. up to 8-18 months post-operatively. It was established up to animal trial stage that 50N50H samples [with 50-55% porosity, average pore size 110 μm, higher interconnectivity (10-100 μm), and moderately high
drug adsorption efficiency (50%)] showed efficient drug release up to 42 days than parenteral group based on
infection eradication and new bone formation. In vivo human bone showed gradual evidence of new bone formation and fracture union with organized callus without recurrence of
infection even after 8 months. This may be a new, alternative, cost effective and ideal therapeutic strategy for chronic
osteomyelitis treatment in human patients.