Histomorphometric evaluation of a novel antimicrobial-loaded bone substitute remodeling in experimental chronic osteomyelitis

Background. Chronic osteomyelitis remains a challeng-ing problem in modern orthopedics, requiring simulta-neous eradication of infection and bone defect recon-struction. The use of biodegradable bone substitutes with antimicrobial properties represents a promising approach. Objective. Histomorphometric evaluation of remodeling processes of an original bone substitute material impregnated with vancomycin in experimental chronic osteomyelitis treatment. Materials and meth-ods. The study was performed on 9 rabbits with infected bone defect modeling in the proximal tibial metaphysis. After chronic osteomyelitis development, surgical de-bridement was performed with defect replacement using original biodegradable mineralized bone graft material impregnated with vancomycin. Histomorphometric anal-ysis was conducted at 14, 45, and 90 days postoperative-ly. Results. Progressive decrease in relative inflammation area from 78.19 to 32.65% (p<0.001) and necrotic bone proportion from 57.31 to 34.59% by day 90 was revealed. Osteoblastic activity significantly increased from 3.99 to 11.37% (p=0.016), while osteoclastic activity remained stable (4.39–3.21%). Three consecutive phases of material integration were established: early inflammatory, interme-diate reparative, and late remodeling. Conclusion. The in-vestigated bone substitute material effectively suppresses infection and creates favourable conditions for physiolog-ical reparative osteogenesis, supporting its potential for clinical application