A Journey into Animal Models of Human Osteomyelitis: A Review

Abstract

Osteomyelitis is an infection of the bone characterized by progressive inflammatory destruction and apposition of new bone that can spread via the hematogenous route (hematogenous osteomyelitis (HO)), contiguous spread (contiguous osteomyelitis (CO)), and direct inoculation (osteomyelitis associated with peripheral vascular insufficiency (PVI)). Given the significant financial burden posed by osteomyelitis patient management, the development of new preventive and treatment methods is warranted. To achieve this objective, implementing animal models (AMs) of infection such as rats, mice, rabbits, avians, dogs, sheep, goats, and pigs might be of the essence. This review provides a literature analysis of the AMs developed and used to study osteomyelitis. Historical relevance and clinical applicability were taken into account to choose the best AMs, and some study methods are briefly described. Furthermore, the most significant strengths and limitations of each species as AM are discussed, as no single model incorporates all features of osteomyelitis. HO’s clinical manifestation results in extreme variability between patients due to multiple variables (e.g., age, sex, route of infection, anatomical location, and concomitant diseases) that could alter clinical studies. However, these variables can be controlled and tested through different animal models.

Piperacillin Steady State Concentrations in Target Tissues Relevant for PJI Treatment—A Randomized Porcine Microdialysis Study Comparing Continuous Infusion with Intermittent Short-Term Infusion

“…However, the different dosages were opted for to mirror standard clinical dosing during the two administration forms. Pigs have a similar mineral bone composition to humans, and the bone size allows for microdialysis catheter placement [ 33 ]. Yet, the clinical translation of the results is still limited by the fact that this is an experimental study on pigs, approximately five months old and still growing with an active epiphyseal plate, in contrast to the typical adult PJI patient.…”

The Role of Biofilms in the Pathogenesis of Animal Bacterial Infections

“…A number of animal models using pigs, dogs, chickens, sheep, goats, rabbits, and mice have been designed to study osteomyelitis [ 89 , 90 ]. Johansen et al [ 91 ] inoculated three groups of pigs of three animals each with S. aureus in the right femoral artery.…”

The osteoblast secretome in Staphylococcus aureus osteomyelitis

“…Dissection of the mechanisms underlying bone infection is hindered by the involvement of a variety of cells within a complex, not easily accessible microenvironment. In vivo models have contributed significantly to our understanding of osteomyelitis and remain a valuable tool, even though they have inherent limitations (e.g., difficulties related to joint dimension and surgery procedures in small animals; different cortical bone composition and structure), as recently reviewed ( 98 , 99 ).…”