S53P4 Bioactive Glass Granules for the Management of Bone, Joint, and Related Soft-Tissue Infections: An Updated Review.

BACKGROUND

Bioactive glass S53P4 has drawn increasing interest for its use in managing chronic osteomyelitis, infected non-unions, and related soft-tissue infections. This review synthesizes clinical evidence with emphasis on comparative studies versus autologous bone grafts, allografts, and antibiotic carriers.

MATERIAL AND

METHODS

We performed a comprehensive search of PubMed, EMBASE, and Scopus (January 2013 to September 2025) that identified human clinical studies reporting outcomes of S53P4 in bone, joint, and related soft-tissue infections. Search terms combined 'S53P4' OR 'bioactive glass' with 'osteomyelitis', 'bone infection', 'infected non-union', 'joint infection', and 'dead space management'. The data were screened, reviewed, extracted, and analyzed in accordance with the PRISMA guideline.

RESULTS

Across heterogeneous cohorts, infection eradication rates typically range from 80-95% with S53P4, bone healing is comparable to autograft, and complication rates are low. Comparative data suggest non-inferior infection control and bone consolidation relative to autograft/antibiotic-polymethylmethacrylate, with potential advantages for one-stage care and reduced length of stay.

CONCLUSION

S53P4 bioactive glass provides infection control and bone regeneration outcomes comparable to autograft and selected antibiotic carriers in chronic osteomyelitis and infected non-unions. Its antimicrobial and osteoconductive properties enable effective one-stage treatment in many cases, with a favorable safety profile and potential cost savings. High-quality randomized trials remain limited, but current evidence supports S53P4 as a viable, cost-effective adjunct in orthopedic infection surgery.