Journal
JOURNAL OF ORTHOPAEDIC RESEARCH
Volume 35, Issue 10, Pages 2211-2221Publisher
WILEY
DOI: 10.1002/jor.23505
Keywords
animal model; osteomyelitis; peri-prosthetic infection; S. aureus
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Funding
- Danish Medical Research Council [4005-00035B]
- European Union's Horizon research and innovation programme under NOMORFILM project [634588]
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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. (C) 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.
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