A novel porcine model of implant associated osteomyelitis: a comprehensive analysis of local, regional and systemic response

Louise Kruse Jensen, Janne Koch, Kirstine Dich-Jorgensen, Bent Aalbaek, Andreas Petersen, Kurt Fuursted, Thomas Bjarnsholt, Kasper Nørskov Kragh, Mikkel Tøtterup, Mats Bue, Pelle Hanberg, Kjeld Søballe, Peter M. H. Heegaard, Henrik Elvang Jensen

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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 (>108 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 104 CFU (n = 26) or 102 and 103 CFU (n = 6). All animals were euthanized five 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. This article is protected by copyright. All rights reserved
    Original languageEnglish
    JournalJournal of Orthopaedic Research
    Issue number10
    Pages (from-to)2211-2221
    Publication statusPublished - 2017


    • Animal model
    • Osteomyelitis
    • Peri-prosthetic infection
    • S. aureus


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