Features of structural changes in the joint components (synovial membrane, articular cartilage, subchondral bone) under the conditions of adjacent limb segment osteomyelitis are poorly understood and require thorough histological studies. Purpose Сomparative assessment of the structural reorganization of the main components of the distal articular end of the femur in experimental modeling of osteomyelitis. Material and methods Objects: distal metaphyses of the femur of intact rats (n = 5) and experimental ones (n = 16) in the conditions of modeled osteomyelitis of the femur. The culture of S. aureus was injected into the medullary canal in the experimental animals (n = 8) while saline was injected in the control group (n = 8). The animals were taken out of the experiment on the 21st day. Methods: histological, morphometric, and statistical methods were used. Results In the control group, the articular cartilage, subchondral bone plate, and subchondral zone retained their normal structure. Synovitis was not revealed. The values of the morphometric parameters were comparable with the intact norm. In the experimental group, bone microsequesters, osteoclastic resorption of the subchondral bone plate, inflammatory infiltration with the content of plasma cells and neutrophils were detected in the subchondral zone. Histological changes in the articular cartilage according to the classification of the International Society OARSI (2006) corresponded to grades 1 to 3 and were accompanied by synovitis. There was a significant (р < 0.05) decrease in the thickness of non-calcified cartilage, a significant twofold decrease in the thickness of the subchondral bone plate, while the values of the thickness of the calcified cartilage exceeded those in the control group and the intact norm. Conclusion Under the conditions of an experimental model of chronic osteomyelitis of the femur, the revealed structural changes in the subchondral zone contribute to the progression of the destruction of the subchondral bone plate, articular cartilage and synovitis. This model of chronic osteomyelitis can be used to experimentally study various therapeutic strategies aimed at modifying subchondral bone remodeling and relieving synovitis.
The increase in the incidence of osteomyelitis requires further development of effective methods for the prevention and elimination of the osteomyelitis process. Currently, a promising direction is the use of direct electric current, which has an antimicrobial effect. However, its use in medical practice is limited due to the lack of clear recommendations. The study was carried out on 18 rats (Wistar), divided into 3 groups: control and 2 experimental. In rats of all groups, osteomyelitis of the femur was simulated by introducing Staphylococcus aureus (1×108 CFU, MSSA) into the medullary canal with the installation of an intramedullary metal implant secured with an external fixation device. In the postoperative period, the animals of the experimental groups underwent sessions of local electric exposure (in experimental group 1 -on days 0, 2, 4, 6, in experimental group 2 -on days 7, 9, 11, 13) with a constant electric current of 150 mAm for 1 minutes, using fixing elements as electrodes. The rats of the control group did not undergo electrical stimulation sessions. Animals were observed for 21 days. In all groups of animals, clinical and radiological signs of an inflammatory process in the area of surgical intervention were revealed: soft tissue edema, exudate outflow, changes in temperature and body weight, lysis and resorption of bone tissue around pin fixators, periosteal reaction, and uneven thickness of the cortical bone plate. In rats of the experimental group 2, a more passive course of the infection was noted, which led to a decrease in the clinical signs of inflammation and a smoothing of the course of destruction processes at the end of the experiment. Thus, the obtained results indicate the need for further study of the effect of direct electric current on the development of bone infection.
Неуклонный рост частоты встречаемости остеомиелита в последние годы связан с расширением рекомендаций по применению остеосинтеза с использованием металлоконструкций при патологии костно-мышечной системы. Изучение особенностей развития остеомиелита у экспериментальных животных позволяет разрабатывать и совершенствовать стратегии профилактики, диагностики и лечения данного заболевания. Исследование проведено на 13 лабораторных крысах линии Вистар, разделенных на 2 группы: опытную и контрольную. Крысам опытной группы на границе верхней и средней трети диафиза бедренной кости формировали трепанационное отверстие с последующей инокуляцией в костномозговой канал 1×10 8 КОЕ Staphylococcus aureus и интрамедуллярным введением спицевого фиксатора. На уровне нижней трети бедренной кости осуществляли консольное введение второй спицы. Далее обе спицы соединяли между собой методом армирования и заливки самотвердеющей пластмассой. Крысам контрольной группы выполняли аналогичные этапы оперативного вмешательства, но не проводили инфицирования костномозгового канала. Оценку состояния животных осуществляли по клиническим и рентгенологическим параметрам в течение 21 суток. В контрольной группе клинических и рентгенологических признаков остеомиелита не выявлено. В опытной группе клинические признаки инфекционного процесса включали локальный отек мягких тканей, выделение гнойного экссудата из спицевых каналов, нарушение функции коленного сустава. Рентгенологические признаки воспаления на 15-е сутки были ограничены интрамедуллярным пространством, а к 21-м суткам воспалительный процесс распространялся на все структурные элементы кости. Таким образом, клинико-рентгенологическая картина развития воспалительного процесса у крыс в условиях эксперимента соответствовала картине остеомиелита, наблюдаемой у человека. Ключевые слова: остеомиелит, инфекционные осложнения, крыса, Staphylococcus aureus, металлоостеосинтез, рентгенографическое исследование.
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