MINIMALLY INVASIVE AND MICROSURGICAL SURGERY IN OSTEOMYELITIS: ADVANCES, CLINICAL RESULTS, AND FUTURE PERSPECTIVES

• DOI: https://doi.org/10.22533/at.ed.1595312530093

• Palavras-chave: Osteomyelitis; Minimally invasive surgery; Microsurgery; Bone debridement; Bone reconstruction.

• Keywords: Osteomyelitis; Minimally invasive surgery; Microsurgery; Bone debridement; Bone reconstruction.

• Abstract:

  Introduction: Osteomyelitis is one of the most complex musculoskeletal infections, whose surgical management has evolved towards minimally invasive and microsurgical techniques that seek to improve infection control and functional recovery.
  Objective: To analyze the advances, clinical results, and future prospects of minimally invasive surgery and microsurgery in the treatment of osteomyelitis, based on the most recent scientific evidence.
  Methodology: A narrative review was conducted in the PubMed, Scopus, Web of Science, and Cochrane Library databases, including articles published between 2020 and 2025. Original studies, systematic reviews, meta-analyses, and clinical series evaluating minimally invasive techniques (arthroscopy, endoscopy, percutaneous debridement) and microsurgical techniques (vascularized free flaps, tissue reconstructions) in osteomyelitis were selected.
  Results: Minimally invasive surgery proved effective in localized cases, with lower morbidity rates, reduced hospital stays, and better functional preservation. Microsurgery achieved success rates of 85–95% in the reconstruction of bone and soft tissue defects, with low recurrence of infection. Both techniques showed significant benefits over traditional open surgery, although they have limitations related to technological availability, the learning curve, and costs.
  Conclusions: Minimally invasive and microsurgical techniques represent a paradigm shift in the treatment of osteomyelitis, with encouraging clinical results. The future integration of computer navigation, 3D printing, robot-assisted surgery, and regenerative therapies will consolidate a hybrid model of surgical management, focused on precision, personalization, and improving patients' quality of life.