Bacterial osteomyelitis in veterinary orthopaedics: Pathophysiology, clinical presentation and advances in treatment across multiple species.
Authors: Gieling Fabian, Peters Sarah, Erichsen Christoph, Richards R Geoff, Zeiter Stephan, Moriarty T Fintan
Journal: Veterinary journal (London, England : 1997)
Summary
# Editorial Summary Bacterial osteomyelitis remains one of the most vexing complications in veterinary orthopaedics, particularly when infections develop around surgical implants used to stabilise fractures, yet current treatment success rates remain disappointingly modest. This 2019 review synthesised the existing literature across five domestic species—cats, dogs, horses, cattle and camelids—to consolidate what is known about disease classification, clinical presentation patterns, causative organisms, and established therapeutic approaches specific to each species. The authors identified that whilst surgical implant-associated infections frequently demand device removal to control osteolysis and bacterial burden, this creates an awkward clinical dilemma between infection eradication and compromised fracture stability. Beyond conventional management strategies, the review examined emerging treatment modalities derived from human orthopaedic research, including advanced antimicrobial delivery systems and novel biological approaches that hold promise for improving outcomes in veterinary patients. For equine and production animal practitioners, this synthesis underscores the importance of species-specific infection prevention protocols, judicious antibiotic selection based on culture and sensitivity, and consideration of innovative treatment options when traditional interventions plateau—particularly relevant given the high stakes of managing osteomyelitis in performance horses and valuable breeding stock.
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Practical Takeaways
- •When treating orthopedic cases with implants in horses and other species, maintain high suspicion for osteomyelitis development as implants significantly increase infection risk and complicate treatment decisions
- •Early diagnosis and aggressive intervention (which may include implant removal despite fracture healing concerns) may be necessary to prevent chronic bone infection and osteolysis complications
- •Stay informed about emerging treatment protocols from human orthopaedic medicine, as novel therapeutic approaches are increasingly being adapted for veterinary osteomyelitis management
Key Findings
- •Bacterial osteomyelitis in veterinary patients is frequently associated with surgical implant devices used for fracture stabilization and healing
- •Management often requires removal of surgical implants to eradicate infection, creating a clinical dilemma between infection control and fracture stability
- •Review covers species-specific presentations across cats, dogs, horses, cattle, and camelids with focus on classification, etiology, and therapeutic interventions
- •Emerging treatment options from human medicine research are applicable to current and future veterinary osteomyelitis management