Journal of Orthopaedic Surgery and Research最新文献

{"title":"Effects of Jintiange on the healing of osteoporotic fractures in aged rats.","authors":"Jie Liu, Ting-Ting Liu, Hai-Cheng Zhang, Chen Li, Wei Wei, Ai-Jun Chao","doi":"10.1186/s13018-024-05351-1","DOIUrl":"10.1186/s13018-024-05351-1","url":null,"abstract":"<p><strong>Objective: </strong>To examine the effects of Jintiange on enhancing the healing of osteoporotic fractures in aged rats.</p><p><strong>Methods: </strong>An osteoporotic fracture model of femur was established using 70 SD rats (aged > 12 months), which were randomly numbered and divided into an experimental group and a control group, each with an equal sample size (n = 35). The experimental group received Jintiange capsule ingredients via intragastric administration, while the control group received an equal volume of saline via the same method. X-ray examinations were conducted at the 4th and 12th weeks to evaluate fracture healing in the rats. After 12 weeks, micro-CT scanning was employed to assess the microstructure of the healthy femurs, and the parameters of the experimental and control groups were compared.</p><p><strong>Results: </strong>After 4 weeks, the mean fracture healing scores were 0.78 ± 0.43 in the experimental group and 0.56 ± 0.51 in the control group. After 12 weeks, the mean scores were 1.50 ± 0.71 in the experimental group and 0.96 ± 0.68 in the control group. The scores in the experimental group were higher than those in the control group (P < 0.05). Micro-CT examination of the femurs showed an improvement trend in bone microarchitecture in the experimental group, indicated by increased bone volume fraction (BV/TV), trabecular number (Tb. N), and trabecular thickness (Tb. Th). However, these improvements were not statistically significant. A negative correlation with statistical significance was observed between trabecular separation (Tb. Sp) and fracture healing scores.</p><p><strong>Conclusions: </strong>Jintiange may promote osteoporotic fracture healing in aged rats by enhancing bone microstructure.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"19 1","pages":"828"},"PeriodicalIF":2.8,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11657282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing the new diagnostic model by integrating bioinformatics and machine learning for osteoarthritis.","authors":"Jian Du, Tian Zhou, Wei Zhang, Wei Peng","doi":"10.1186/s13018-024-05340-4","DOIUrl":"10.1186/s13018-024-05340-4","url":null,"abstract":"<p><strong>Background: </strong>Osteoarthritis (OA) is a common cause of disability among the elderly, profoundly affecting quality of life. This study aims to leverage bioinformatics and machine learning to develop an artificial neural network (ANN) model for diagnosing OA, providing new avenues for early diagnosis and treatment.</p><p><strong>Methods: </strong>From the Gene Expression Omnibus (GEO) database, we first obtained OA synovial tissue microarray datasets. Differentially expressed genes (DEGs) associated with OA were identified through utilization of the Limma package and weighted gene co-expression network analysis (WGCNA). Subsequently, protein-protein interaction (PPI) network analysis and machine learning were employed to identify the most relevant potential feature genes of OA, and ANN diagnostic model and receiver operating characteristic (ROC) curve were constructed to evaluate the diagnostic performance of the model. In addition, the expression levels of the feature genes were verified using real-time quantitative polymerase chain reaction (qRT-PCR). Finally, immune cell infiltration analysis was performed using CIBERSORT algorithm to explore the correlation between feature genes and immune cells.</p><p><strong>Results: </strong>The Limma package and WGCNA identified a total of 72 DEGs related to OA, of which 12 were up-regulated and 60 were down-regulated. Then, the PPI network analysis identified 21 hub genes, and three machine learning algorithms finally screened four feature genes (BTG2, CALML4, DUSP5, and GADD45B). The ANN diagnostic model was constructed based on these four feature genes. The AUC of the training set was 0.942, and the AUC of the validation set was 0.850. In addition, the qRT-PCR validation results demonstrated a significant downregulation of BTG2, DUSP5, and GADD45 mRNA expression levels in OA samples compared to normal samples, while CALML4 mRNA expression level exhibited an upregulation. Immune cell infiltration analysis revealed B cells memory, T cells gamma delta, B cells naive, Plasma cells, T cells CD4 memory resting, and NK cells The abnormal infiltration of activated cells may be related to the progression of OA.</p><p><strong>Conclusions: </strong>BTG2, CALML4, DUSP5, and GADD45B were identified as potential feature genes for OA, and an ANN diagnostic model with good diagnostic performance was developed, providing a new perspective for the early diagnosis and personalized treatment of OA.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"19 1","pages":"832"},"PeriodicalIF":2.8,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11658098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does scapular dyskinesia affect upper extremity performance, proprioception, and body image in kickboxers? Case-control study.","authors":"Cetin Sayaca, Burak Erkan","doi":"10.1186/s13018-024-05209-6","DOIUrl":"10.1186/s13018-024-05209-6","url":null,"abstract":"<p><strong>Background: </strong>Scapular Dyskinesia (SD) is detected more frequently in athletes who do overhead activity sports. SD is more common in kickboxers who actively use their upper extremities. This study was conducted to compare upper extremity stabilization, proprioception and body image in kickboxers with and without SD.</p><p><strong>Methods: </strong>Kickboxing athletes participating in the study were divided into two groups according to whether they had SD or not. Presence of SD with Lateral Scapular Slide Test; Shoulder proprioception sense with digital inclinometer (Dualer IQ Pro, JTECH Medical Industries) at 40, 70, 90 and 135 degrees; Shoulder joint stabilization was evaluated with the Closed Kinetic Chain Upper Extremity Stabilization Test, and body image was evaluated with the Body Assessment Scale.</p><p><strong>Results: </strong>A total of 56 male kickboxing athletes with (n:27) and without (n:29) SD between the ages of 18-35 were included in the study. There was no difference between the groups regarding age, height, weight, body mass index, and 40° with 135° shoulder abduction proprioception sense (p > 0.05). There were differences between the groups in terms of sports history, 70° and 90° shoulder abduction proprioception sense, shoulder stabilization and body image (p: 0.001; p: 0.003; p: 0.003; p: 0.012, respectively).</p><p><strong>Conclusion: </strong>Shoulder proprioception, shoulder joint stabilization, and body image in kickboxers with SD were better than kickboxers without SD. In addition, Kickboxers with SD performed in this sport for a longer time than kickboxers without SD.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"19 1","pages":"829"},"PeriodicalIF":2.8,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11657585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors analysis and predictive model of degree I degenerative lumbar spondylolisthesis.","authors":"RuiYang Wang, Neng Ru, Qing Liu, Fan Zhang, Yu Wu, ChangJin Guo, Jie Liang","doi":"10.1186/s13018-024-05346-y","DOIUrl":"10.1186/s13018-024-05346-y","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective Case-Control Study.</p><p><strong>Background: </strong>There have been some previous studies on the risk factors associated with lumbar spondylolisthesis, but there are few studies on the risk factors for disease progression in mild degenerative lumbar spondylolisthesis (DLS). To analyze the risk factors associated with aggravation of spondylolisthesis in patients with grade I degenerative spondylolisthesis and construct a prediction model.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 220 patients diagnosed with DLS who were admitted to our hospital between January 2019 and January 2023. Data collected included gender, age, body mass index (BMI), diabetes, hypertension, occupation, and imaging parameters.</p><p><strong>Results: </strong>A total of 220 patients were included in this study, including 111 males and 109 females; 178 patients with no aggravation of lumbar spondylolisthesis (group A) and 42 patients with aggravation of lumbar spondylolisthesis (group B). Progression of grade I DLS was associated with single factors such as age, BMI, Occupation, vertebral CT value, facet joint angle (FJA), Modic change (MC), Pfirrmann grade of intervertebral disc (PG), Facet joint effusion (FJE), osteophyte formation, and Percentage of the Fat Infiltration (FIA%) of multifidus muscle (MM). BMI, FJA, PG, and FI% of MM had a significant impact on disease progression in lumbar spondylolisthesis.</p><p><strong>Conclusion: </strong>BMI, FJA, PG, and FIA% of MM were independent risk factors for the progression of degenerative spondylolisthesis. The risk prediction model was established by including the above four variables and nomograms were drawn. The internal validation proved that the model had good discrimination, calibration, and clinical practicability.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"19 1","pages":"831"},"PeriodicalIF":2.8,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11657725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for surgical site infection after patellar fracture surgery in the elderly.","authors":"Hui Qi, Wei Duan, Ruili Jia, Shuai Wang, Ming An, Yubin Long","doi":"10.1186/s13018-024-05335-1","DOIUrl":"10.1186/s13018-024-05335-1","url":null,"abstract":"<p><strong>Background: </strong>Patellar fractures are a common knee injury among elderly patients, with a high risk of developing surgical site infections (SSI) postoperatively, which severely affects patient prognosis and quality of life. Elderly patients are more susceptible to SSI due to various factors such as decreased immune function and chronic diseases. Therefore, identifying the risk factors for SSI is of great clinical significance for prevention.</p><p><strong>Objective: </strong>This study aims to analyze the risk factors for postoperative SSI in elderly patients with patellar fractures, providing a basis for developing more effective clinical prevention and treatment strategies.</p><p><strong>Methods: </strong>This retrospective study collected data from 856 elderly patients who underwent patellar fracture surgery at Baoding First Central Hospital between January 2017 and December 2023. Patients were divided into SSI and non-SSI groups based on the occurrence of SSI, and their demographic data, comorbidities, and laboratory results were analyzed. Logistic regression was used to identify independent risk factors for SSI, and ROC curve analysis was conducted to determine the optimal cutoff point for predictive indicators.</p><p><strong>Results: </strong>The incidence of SSI was found to be 2.1%. Univariate analysis showed that BMI, surgical delay, diabetes, hematocrit (HCT), and albumin (ALB) were significantly associated with SSI. Logistic regression analysis further confirmed that BMI (p = 0.043), surgical delay (p = 0.000), HCT (p = 0.038), ALB (p = 0.015), and diabetes (p = 0.022) were independent risk factors for SSI. ROC curve analysis indicated that the optimal cutoff points for BMI, HCT, and ALB were 25.39 kg/m², 35.62%, and 39.3 g/L, respectively, with an AUC of 0.794 for the combined predictive indicators.</p><p><strong>Conclusion: </strong>High BMI, surgical delay, diabetes, low HCT, and low ALB are independent risk factors for postoperative SSI in elderly patients with patellar fractures. Preoperative management targeting these high-risk factors, such as optimizing patient weight, controlling diabetes, and improving nutritional status, can effectively reduce the incidence of SSI and improve postoperative outcomes. Future multicenter studies may further validate these findings and provide additional prevention strategies.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"19 1","pages":"830"},"PeriodicalIF":2.8,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11657550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancements in the treatment of osteochondral lesions of the talus.","authors":"Lianjie Cheng, Xuena Wang","doi":"10.1186/s13018-024-05314-6","DOIUrl":"10.1186/s13018-024-05314-6","url":null,"abstract":"<p><p>Osteochondral lesions of the talus (OLT) are common ankle joint pathologies, often caused by traumatic or non-traumatic factors. Due to the anatomical characteristics and limited blood supply of the talus, the spontaneous healing capacity of OLT is poor, posing challenges for clinical treatment. Traditional treatments include conservative therapy and surgical interventions, but their efficacy is limited. In recent years, significant advancements in OLT treatment have been achieved with developments in biomaterials science, cell biology, and tissue engineering. This article summarizes the latest research progress in various treatment methods, including conservative treatment, bone marrow stimulation, chondrocyte transplantation, and osteochondral grafting, and evaluates the role of biological augmentation agents such as platelet-rich plasma (PRP) and concentrated bone marrow aspirate (CBMA) in promoting cartilage repair. Additionally, the application of biological scaffold technology offers new prospects for cartilage regeneration. Although emerging therapies show potential in clinical practice, further research is needed to evaluate their long-term efficacy, indications, and safety. This article aims to provide valuable references for clinicians, researchers, and policymakers, promoting the development and refinement of OLT treatment strategies.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"19 1","pages":"827"},"PeriodicalIF":2.8,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11622651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploration and breakthrough in the mode of intervertebral disc cell death may lead to significant advances in treatments for intervertebral disc degeneration.","authors":"Heng Chen, Tian Tang, Congyang Xue, Xin Liu, Zhipeng Xi, Lin Xie, Ran Kang","doi":"10.1186/s13018-024-05280-z","DOIUrl":"10.1186/s13018-024-05280-z","url":null,"abstract":"<p><p>Low back pain caused by intervertebral disc degeneration (IDD) has emerged as a significant global public health concern, with far-reaching consequences for patients' quality of life and healthcare systems. Although previous research have revealed that the mechanisms of intervertebral disc cell apoptosis, pyroptosis and necroptosis can aggravate IDD damage by mediating inflammation and promoting extracellular matrix degradation, but they cannot explain the connection between different cell death mechanisms and ion metabolism disorders. The latest study shows that cell death mechanisms such as cellular senescence, ferroptosis, and cuproptosis, and PANopotosis have similar roles in the progression of intervertebral disc degeneration, but not exactly the same damage mechanism. This paper summarizes the effects of various cell death patterns on the disease progression of IDD, related molecular mechanisms and signaling pathways, providing new perspectives and potential clinical intervention strategies for the prevention and treatment of IDD.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"19 1","pages":"825"},"PeriodicalIF":2.8,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11619685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"WTAP mediates IL-1β-induced chondrocyte injury by enhancing CA12 mRNA stability depending on m6A modification.","authors":"Gang Deng, Yizhou Xu, Zhengnan Li, Guangxuan Zeng","doi":"10.1186/s13018-024-05262-1","DOIUrl":"10.1186/s13018-024-05262-1","url":null,"abstract":"<p><strong>Background: </strong>Osteoarthritis (OA) poses a significant risk to the mobility of patients. Carbonic anhydrase 12 (CA12) can boost apoptosis and inflammation in several cancers, but its role in OA is unknown.</p><p><strong>Methods: </strong>Differentially expressed genes in OA were analyzed using the GEO database (GSE169077). RT-qPCR and western blot estimated relative mRNA and protein levels of CA12. Cell viability and apoptosis were estimated by cell counting and flow cytometry assays. Oxidative stress (OxS) was determined by detecting with ROS and MDA levels, as well as CAT and SOD activities. Cytokine levels of IL-6 and TNF-α were detected by ELISA. Parameters associated with apoptosis and extracellular matrix (ECM) were detected by western blot. The m6A modification profile was determined by methylated RNA immunoprecipitation assays.</p><p><strong>Results: </strong>Relative CA12 and wilms' tumor 1-associating protein (WTAP) mRNA and protein levels were overexpressed in OA articular cartilages and IL-1β-challenged chondrocytes CHON-001. CA12 silencing impaired IL-1β-induced cell apoptosis, inflammation, OxS, and ECM degradation in chondrocytes. Yet, CA12 overexpression exerted an opposing function. WTAP reinforced the stability of CA12 mRNA depending on the m6A modification. Furthermore, WTAP knockdown weakened cell apoptosis, inflammation, OxS, and ECM degradation in chondrocytes induced by IL-1β, but these changes were impaired after CA12 overexpression. In addition, WTAP knockdown mitigates cartilage degeneration in DMM-induced mouse models.</p><p><strong>Conclusion: </strong>IL-1β-induced WTAP enhances CA12 mRNA stability depending on m6A modification, thus promoting chondrocyte apoptosis, inflammatory response, OxS, and ECM degradation, providing evidence to support the possibility of WTAP and CA12 as potential targets for OA treatment.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"19 1","pages":"826"},"PeriodicalIF":2.8,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11619656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The presence of a Segond fracture in ACL-injured patients is associated with increased internal tibial rotation on preoperative MRIs.","authors":"Zhi-Yu Zhang, Hong-de Wang, Si-Yao Wang, Pakezhati Maimaitijiang, Cheng Wang","doi":"10.1186/s13018-024-05311-9","DOIUrl":"10.1186/s13018-024-05311-9","url":null,"abstract":"<p><strong>Background: </strong>Segond fracture is considered a component of the anterolateral complex (ALC) injury, yet the underlying cause and clinical outcomes of this bony avulsion remain subjects of debate. Additionally, MRI measurements of altered tibiofemoral position in anterior cruciate ligament (ACL)-injured patients with a Segond fracture have not been reported. The purpose of this study is to measure the rotational tibiofemoral position on MRI in ACL-injured patients with a Segond fracture.</p><p><strong>Methods: </strong>A total of 44 patients with a primary ACL injury and a concomitant Segond fracture were included in the Segond fracture group, with the time from injury to MRI within 3 months. Avulsion was confirmed via preoperative computed tomography (CT) scans. The control group comprised 44 matched patients with primary ACL injury and an MRI-determined ALC injury but without a Segond fracture, also with the time from injury to MRI within 3 months. The MRI-determined ALC injury included injuries to the anterolateral ligament, Kaplan fibers, and anterolateral joint capsule, as identified based on previous studies. Sex, age, and BMI were matched between the two groups using propensity score matching (PSM). Arthroscopic findings, concomitant collateral ligament injuries, and preoperative MRI measurements were compared between the two groups.</p><p><strong>Results: </strong>The Segond fracture group demonstrated a higher frequency of concomitant patellar and femoral trochlear injuries (p = 0.0110) and lateral collateral ligament injuries (p = 0.0121) compared to the control group. Additionally, significantly increased internal rotational tibial subluxation (IRTS) (p = 0.0095) and axial internal tibial rotation (ITR_a) (p = 0.0306) were observed in the Segond fracture group. A strong positive correlation was found between IRTS and ITR_a (r_p = 0.8201), indicating that these two tibial rotation measurement methods were correlated. No significant differences were observed in the measurements of anteroposterior tibiofemoral position and posterior tibial slope (PTS) between the two groups.</p><p><strong>Conclusion: </strong>The presence of a Segond fracture was associated with significantly increased internal tibial rotation measured on MRIs, suggesting that this bony avulsion may represent a more severe form of ALC injury in ACL-injured patients and should be managed with caution.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"19 1","pages":"824"},"PeriodicalIF":2.8,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11616134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biofilm and the effect of sonication in a chronic Staphylococcus epidermidis orthopedic in vivo implant infection model.","authors":"Erik Thorvaldsen Sandbakken, Erling Høyer, Eivind Witsø, Caroline Krogh Søgaard, Alberto Díez-Sánchez, Linh Hoang, Tina Strømdal Wik, Kåre Bergh","doi":"10.1186/s13018-024-05309-3","DOIUrl":"10.1186/s13018-024-05309-3","url":null,"abstract":"<p><strong>Background: </strong>In diagnosing chronic orthopedic implant infections culture of sonicate represents a supplement to tissue cultures. However, the extent to which biofilm forms on implant surfaces and the degree of dislodgement of bacteria by sonication remains unclear. In this in vivo study using a low bacterial inoculum, we aimed to determine whether a variable effect of sonication could be observed in a standardized in vivo model.</p><p><strong>Materials and methods: </strong>Seven Wistar rats underwent surgery with intramuscular implantation of two bone xenograft implants, each containing two steel plates. The grafts were inoculated with approximately 500 colony forming units (CFU) of Staphylococcus epidermidis ATCC 35984. After 20 days the rats were sacrificed, and the steel plates were removed from the bone grafts. Epifluorescence microscopy and scanning electron microscopy (SEM) were used to visualize biofilm formation and dislodgement on the plate surfaces. In addition to cultures of sonicate, a quantitative S. epidermidis specific PCR was developed for enumeration of bacteria.</p><p><strong>Results: </strong>A chronic, low-grade implant infection was successfully established, with all animals remaining in good health. All infected bone graft implants yielded abundant growth of S. epidermidis, with a median of 3.25 (1.6-4.6) × 10⁷ CFU per/graft. We were unable to distinguish infected plates from negative controls using epifluorescence microscopy. On infected plates small colonies of staphylococci were identified by SEM. The number of bacteria detected in the sonicate was low with 500 (100-2400) CFU/plate and 475 (140-1821) copies/plate by qPCR. The difference in area covered by fluorescent material before and after sonication was 10.1 (5.7-12.3) %, p = 0.018.</p><p><strong>Conclusion: </strong>Despite the pronounced infection in the surrounding tissue, only few bacteria were detected on the surface of the steel implants. This is evident from the minimal findings by SEM before sonication, as well as the very low CFU counts and DNA copies in the sonicate. Sonication did not show variable effectiveness, indicating it is a valuable addition to, but not a replacement for biopsy cultures in cases of implant-associated infections with low-virulence microorganisms.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"19 1","pages":"820"},"PeriodicalIF":2.8,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11616123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}