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Early implant‐associated osteomyelitis results in a peri‐implanted bacterial reservoir
Author(s) -
Jensen Louise Kruse,
Koch Janne,
Aalbæk Bent,
Moodley Arshnee,
Bjarnsholt Thomas,
Kragh Kasper Nørskov,
Petersen Andreas,
Jensen Henrik Elvang
Publication year - 2017
Publication title -
apmis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 88
eISSN - 1600-0463
pISSN - 0903-4641
DOI - 10.1111/apm.12597
Subject(s) - osteomyelitis , implant , medicine , staphylococcus aureus , orthopedic surgery , debridement (dental) , surgery , pathology , dentistry , biology , bacteria , genetics
Implant‐associated osteomyelitis ( IAO ) is a common complication in orthopedic surgery. The aim of this study was to elucidate how deep IAO can go into the peri‐implanted bone tissue within a week. The study was performed in a porcine model of IAO . A small steel implant and either 10 4 CFU /kg body weight of Staphylococcus aureus or saline was inserted into the right tibial bone of 12 pigs. The animals were consecutively killed on day 2, 4 and 6 following implantation. Bone tissue around the implant was histologically evaluated. Identification of S. aureus was performed immunohistochemically on tissue section and with scanning electron microscopy and peptide nucleic acid in situ hybridization on implants. The distance of the peri‐implanted pathological bone area ( PIBA ), measured perpendicular to the implant, was significantly larger in infected animals compared to controls (p = 0.0014). The largest differences were seen after 4 and 6 days of inoculation, where PIBA measurements of up to 6 mm were observed. Positive S. aureus bacteria were identified on implants and from 25 μm to 6 mm into PIBA . This is important knowledge for optimizing outcomes of surgical debridement in osteomyelitis.