The classification of chronic osteomyelitis

Abstract

As a result of the heterogeneous nature of chronic osteomyelitis and the complexity of management strategy formulation, more than ten classification systems have been published over the past 40 years. Historical systems, used in the classification of chronic osteomyelitis, remain useful in terms of the description of the nature and origin of the disease. They fail, however, to provide the user with sufficient information in order to select the appropriate treatment strategy. As a result, more comprehensive classifications have subsequently been proposed. Accurate host stratification, in particular, is considered to be essential. The physiological status of the host serves as the primary indicator of the patient’s ability to effect healing of bone and soft tissues, as well as their ability to launch an effective immune response in conjunction with antibiotic therapy. Despite the development of more comprehensive classification systems, many shortcomings remain within the domain of disease classification and host stratification.