Fluorescence-Guided Surgical Debridement of Chronic Osteomyelitis Utilizing Doxycycline Bone Labeling

A Technical Trick Revived

Garrhett G. Via, MD; David A. Brueggeman, MD; Grant M. Slack, BS; James M. Danias, DO; Jennifer L. Jerele, MD


Curr Orthop Pract. 2021;32(5):518-521. 

In This Article


The authors have revived the concept of fluorescence-guided bone debridement based upon the biochemistry of bone labeling by tetracyclines in addition to the natural tendency for live bone to fluoresce. This work has demonstrated that the preoperative administration of doxycycline in a patient with osteomyelitis may allow for augmented surgical debridement of chronically infected bone. Preoperative administration of 100 mg doxycycline twice daily for at least 1 mo coupled with the intraoperative use of an ordinary blacklight as an excitation source is the preferred technique of the senior author. Although variations in the technique do exist and can function quite well, the concept of bone labeling for fluorescent-guided resection of chronic osteomyelitis can be a useful tool in these challenging patients.