Abstract
Chronic osteomyelitis in presence of orthopedic implants is a condition observed in the field of biomaterials as it impairs early bone-implant contact, fixation and integration. In this study, a surgical intramedullary tibial insertion was performed using a titanium wire previously inoculated with Staphylococcus aureus in order to develop an osteomyelitis model in a clinically relevant long bone and in absence of any prophylactic treatment. As such, twenty-two male Sprague-Dawley rats received a sterile or inoculated intramedullary biomaterial with either 2 × 106 or 1 × 107 S. aureus colony forming units. Bacterial burden, inflammation, morphological changes, as well as newly formed bone tissues were evaluated for histopathology following a period of either eight or fifteen days of implantation. The implant inoculated in presence of the highest bacterial load was effective to produce significant periprosthetic infection observations in addition to hard and soft tissue inflammation consistent with the development of osteomyelitis. In contrast, neither the sterile nor the low-dose implant inoculation showed inflammation and clinical infection signs, but rather produced an expected bone remodeling and appropriate healing associated with biomaterial implantation. Complete health assessment is presented with histopathological periprosthetic results.
Highlights
Chronic orthopedic periprosthetic joint infection is a recognized complication in biomaterials science since it has an impact on early implant integration, fixation and osseointegration
Biomaterials for disease induction were represented by intramedullary pins [Ti-6Al-4V titanium alloy TI Kirschner wires (K-wires); Ø1.0 mm × 150 mm; DePuy Synthes, Monument, CO, United States)], which are traditionally used in orthopedics to help reduce and stabilize fractures, osteotomies and fusions
The organisms were grown in tryptic soy broth (TSB; Alpharmco Laboratory, Montréal, QC, Canada) at 37◦C with intensive shaking at approximately 150 rpm for 12–18 h and diluted with sterile saline in order to achieve a density of 1 × 107 colony forming units (CFUs)/mL
Summary
Chronic orthopedic periprosthetic joint infection is a recognized complication in biomaterials science since it has an impact on early implant integration, fixation and osseointegration. It is estimated that 8– 15% of total joint arthroplasty failures are directly related to an infection (Lentino, 2003; Kurtz et al, 2008; Puckett et al, 2010). With changes to patient demographics, the incidence is expected to augment as elective surgeries are predicted to increase with prosthetic device wear over time. This will necessarily represent a significant economic burden on our healthcare system and society with consequent economic implications (Kurtz et al, 2008, 2012; Cram et al, 2012; Hernández-Vaquero et al, 2013)
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