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Related Experiment Videos

Infection in experimental arthroplasties.

R T Southwood1, J L Rice, P J McDonald

  • 1Flinders Medical Centre, Bedford Park, Adelaide, South Australia.

Clinical Orthopaedics and Related Research
|November 1, 1987
PubMed
Summary

This study shows that Staphylococcus aureus bone infections around implants are best established by direct injection. Antibiotics, especially gentamicin-impregnated bone cement, significantly reduce infection risk in this rabbit model.

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Area of Science:

  • Orthopedic Surgery
  • Infectious Diseases
  • Biomaterials Science

Background:

  • Implant-associated infections are a significant complication in arthroplasty surgery.
  • Developing reliable experimental models is crucial for evaluating preventative strategies.

Purpose of the Study:

  • To investigate the efficacy of different inoculation routes for establishing experimental Staphylococcus aureus infections in rabbit arthroplasties.
  • To assess the effectiveness of antibiotic-loaded bone cement and systemic antibiotics in preventing infection.

Main Methods:

  • Surgical implantation of femoral prostheses and bone cement in rabbits.
  • Inoculation of Staphylococcus aureus via direct medullary injection or intravenous administration.
  • Monitoring infection markers, including erythrocyte sedimentation rate (ESR).

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  • Evaluation of antibiotic interventions (gentamicin-impregnated cement, flucloxacillin, imipenem, rifampicin).
  • Main Results:

    • Direct femoral medullary inoculation of 10^3 Staphylococcus aureus consistently established periprosthetic infection.
    • Intravenous inoculation required significantly higher bacterial doses to induce infection, indicating difficulty in reproducing hematogenous spread.
    • Erythrocyte sedimentation rate (ESR) was identified as the most reliable clinical indicator of infection.
    • Gentamicin-impregnated cement demonstrated substantial protective effects, requiring 60-fold higher bacterial inocula.
    • Flucloxacillin, Imipenem, and Rifampicin also provided significant protection against infection.

    Conclusions:

    • Direct medullary inoculation is a reliable method for creating experimental periprosthetic joint infections.
    • Antibiotic-loaded bone cement and specific systemic antibiotics are highly effective in preventing Staphylococcus aureus arthroplasty infections.
    • This rabbit model provides a valuable platform for testing prophylactic strategies against implant-associated infections.