A new sequential animal model for infection-related non-unions with segmental bone defect View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2020-05-27

AUTHORS

Lars Helbig, Thorsten Guehring, Nadine Titze, Dennis Nurjadi, Robert Sonntag, Jonas Armbruster, Britt Wildemann, Gerhard Schmidmaier, Alfred Paul Gruetzner, Holger Freischmidt

ABSTRACT

BACKGROUND: The treatment of fracture-related infections (FRI) is still a challenge for orthopedic surgeons. The prevalence of FRI is particularly high in open fractures with extensive soft-tissue damage. This study aimed to develop a new two-step animal model for non-unions with segmental bone defects, which could be used to evaluate new innovative bone substitutes to improve the therapeutic options in humans with FRI and bone defects. METHODS: After randomization to infected or non-infected groups, 30 Sprague-Dawley rats underwent a transverse osteotomy of the mid-shaft femur with a 5 mm defect. Additionally, the periosteum at the fracture zone was cauterized at both sides. After intramedullary inoculation with 103 CFU Staphylococcus aureus (infected group) or PBS (non-infected group), a fracture stabilization was done by intramedullary K-wires. After 5 weeks, the bone healing process was evaluated, and revision surgery was performed in order to obtain increased bone healing. The initial K-wires were removed, and debridement of the osteotomy-gap was done followed by a more stable re-osteosynthesis with an angle-stable plate. After further 8 weeks all rats were euthanized and the bone consolidation was tested biomechanically and the callus formation quantitatively by micro-CT analysis. RESULTS: We developed and presented a new two-stage non-union animal model through a targeted S. aureus infection. After 5 weeks, all animals showed a non-union irrespective of assignment to the infected and non-infected group. Lane and Sandhu score showed a higher callus formation in the infected group. In all infected animals, the inoculated S. aureus strain was detected in the revision surgery. The second surgery did not improve bone healing, as shown by the Lane Sandhu score and in the μ-CT analysis. Similarly, biomechanical testing showed in both groups a significantly lower maximum torque as compared to the contralateral side (p < 0.0001). CONCLUSIONS: We were able to successfully develop a new two-stage non-union animal model, which reflects a genuine clinical situation of an infection-related non-union model with segmental bone defects. This model could be used to evaluate various therapeutic anti-infectious and osteoinductive strategies in FRIs. More... »

PAGES

329

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s12891-020-03355-6

DOI

http://dx.doi.org/10.1186/s12891-020-03355-6

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1127953217

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/32460740


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43 biomechanical testing
44 bone
45 bone consolidation
46 bone defects
47 bone healing
48 bone healing process
49 callus formation
50 challenges
51 clinical situations
52 consolidation
53 contralateral side
54 damage
55 debridement
56 defects
57 extensive soft tissue damage
58 femur
59 formation
60 fracture stabilization
61 fracture zones
62 fracture-related infection
63 fractures
64 genuine clinical situation
65 group
66 healing
67 healing process
68 highest callus formation
69 humans
70 infected group
71 infection
72 infection-related non-union model
73 innovative bone
74 inoculation
75 intramedullary inoculation
76 lanes
77 lower maximum torque
78 maximum torque
79 mid-shaft femur
80 model
81 new innovative bone
82 new sequential animal model
83 non-infected group
84 non-union animal model
85 non-union model
86 open fractures
87 options
88 order
89 orthopaedic surgeons
90 osteoinductive strategies
91 osteotomy
92 periosteum
93 plate
94 prevalence
95 prevalence of FRI
96 process
97 randomization
98 rats
99 revision surgery
100 scores
101 second surgery
102 segmental bone defects
103 sequential animal model
104 side
105 situation
106 soft tissue damage
107 stabilization
108 strains
109 strategies
110 study
111 surgeons
112 surgery
113 testing
114 therapeutic options
115 torque
116 transverse osteotomy
117 treatment
118 two-stage non-union animal model
119 two-step animal model
120 weeks
121 wire
122 zone
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