A systematic review on current osteosynthesis-associated infection animal fracture models
Publication in refereed journal

替代計量分析
.

其它資訊
摘要Objective
Osteosynthesis-associated infection is a challenging complication post fracture fixation, burdening the patients and the orthopaedic surgeons alike. A clinically relevant animal model is critical in devising new therapeutic strategies. Our aim was to perform a systematic review to evaluate existing preclinical models and identify their applications in aspects of animal selection, bacterial induction, fracture fixation and complications.

Methods
A systematic literature research was conducted in PubMed and Embase up to February 2020. A total of 31 studies were included. Information on the animal, bacterial induction, fracture fixation, healing result and complications were extracted.

Results
Animals selected included murine (23), rabbit (6), ewe (1) and goat (1). Larger animals had enabled the use of human-sized implant, however small animals were more economical and easier in handling. Staphylococcus aureus (S. aureus) was the most frequently chosen bacteria for induction. Bacterial inoculation dose ranged from 102−8 ​CFU. Consistent and replicable infections were observed from 104 ​CFU in general. Methods of inoculation included injections of bacterial suspension (20), placement of foreign objects (8) and pretreatment of implants with established biofilm (3). Intramedullary implants (13), plates and screws (18) were used in most models. Radiological (29) and histological evaluations (24) in osseous healing were performed. Complications such as instability of fracture fixation (7), unexpected surgical death (5), sepsis (1) and persistent lameness (1) were encountered.

Conclusion
The most common animal model is the S. aureus infected open fracture internally fixated. Replicable infections were mainly from 104 ​CFU of bacteria. However, with the increase in antibiotic resistance, future directions should explore polymicrobial and antibiotic resistant strains, as these will no doubt play a major role in bone infection. Currently, there is also a lack of osteoporotic bone infection models and the pathophysiology is unexplored, which would be important with our aging population.

The translational potential of this article
This systematic review provides an updated overview and compares the currently available animal models of osteosynthesis-associated infections. A discussion on future research directions and suggestion of animal model settings were made, which is expected to advance the research in this field.
著者Ronald M.Y. Wong, Tsz-kiu Li, Jie Li, Wing-Tung Ho, Simon K.-H. Chow, Sharon S.Y. Leung, Wing-Hoi Cheung, Margaret Ip
期刊名稱Journal of Orthopaedic Translation
出版作品名稱A systematic review on current osteosynthesis-associated infection animal fracture models
出版年份2020
月份7
卷號23
出版社Elsevier
頁次8 - 20
國際標準期刊號2214-031X
語言英式英語

上次更新時間 2020-22-11 於 00:22