Source of Support: None, Conflict of Interest: None
From 1974 to 1999. 35 patients with intractable pyogenic and tuberculosis infection of bone and joint were treated by combining local instillation of Cyclophosphamide (CPM) to standard conventional treatment. Topical CPM was first used in 1974 in a 22 year old male to treat tuberculosis of hip which became secondarily infected with Staph aureus following an arthrotomy. With instillation of CPM through a sinus lead to stoppage of discharge within a week and satisfactory progress of healing. Such serendipitous favourable result prompted us to use topical CPM in 34 other patients with intractable bone and joint infection. Healing occurred in 28 (80%) patients. Amongst the 7 patients who did not respond fully, one patient required disarticulation of the shoulder and another patient required removal of a total knee prosthesis. Remaining 5 patients are still under treatment.