Novel porcine model of implant-associated osteomyelitis: A comprehensive analysis of local, regional, and systemic response

Louise Kruse Jensen, Janne Koch, Kristine Dich-Jørgensen, Bent Aalbaek, Andreas Petersen, Kurt Fuursted, Thomas Bjarnsholt, Kasper Nørskov Kragh, Mikkel Tøtterup, Mats Bue, Pelle Hanberg, Kjeld Søballe, Peter M H Heegaard, Henrik Elvang Jensen

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Abstract

Pigs are favorable experimental animals for infectious diseases in humans. However, implant-associated osteomyelitis (IAO) models in pigs have only been evaluated using high-inoculum infection (>10(8) CFU) models in 1975 and 1993. Therefore, the aim of this paper was to present a new low inoculum porcine model of human IAO based on 42 experimental pigs. The model was created by drilling an implant cavity in the tibial bone followed by insertion of a small steel implant and simultaneous inoculation of Staphylococcus aureus bacteria (n = 32) or saline (n = 10). The infected pigs were either inoculated with 10(4) CFU (n = 26) or 10(2) and 10(3) CFU (n = 6). All animals were euthanized 5 days after insertion of implants. Pigs receiving the high-inoculum infections showed a significantly higher volume of bone lesion, number of neutrophils around the implant, concentrations of acute phase proteins in serum, and enlargement of regional lymph nodes. A positive correlation was present between a high number of surrounding neutrophils and high values of all other parameters. Furthermore, a threshold of 40 neutrophils per 10 high power fields for the histopathological diagnosis of high grade IAO was defined.

IN CONCLUSION: This paper describes a novel low-inoculum S. aureus porcine model of IAO which was demonstrated to be reliable, reproducible and discriminative to human IAO, and represents a requested and valuable tool in orthopedic research. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res.

OriginalsprogEngelsk
TidsskriftJournal of Orthopaedic Research
Vol/bind35
Udgave nummer10
Sider (fra-til)2211–2221
ISSN0736-0266
DOI
StatusUdgivet - 2017

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