The role of active immunization therapy as preoperative treatment for chronic osteomyelitis

Background This retrospective study was performed to assess the effectiveness of active immunostimulation therapy with bacterial immunotherapy (BIT) in treatment for chronic osteomyelitis (COM). Materials and methods We analyze 154 patients affected by COM and treated with BIT from 1995 to 2009 at our Institution. Using Cierny and Mader classification, patients were divided according to their clinical status and anatomic nature of septic process. The data were analyzed considering several confounding factors, such as antibiotic therapy and hyperbaric oxygen therapy combined with the administration of BIT. According to clinical and radiographic parameters, patients were considered as unchanged, improved, or healed. Results After a mean follow-up of 40.4 months (median 38 months), healing was achieved in 41.6 % of cases. Multivariate statistical analysis showed that patient’s clinical status is the most important prognostic factor of responding ( p