The osteomyelitis study in the New Zealand white rabbit (NZWR) model: An approach to treatment
INTRODUCTION: Treatment of osteomyelitis is still a major challenge in orthopedics. Study of osteomyelitis and infection requires the use of suitable animal. New Zealand white rabbit (NZWR) (Oryctologus cuniculus) is an acceptable experimental model. It is used for local delivery of antibioti...
| Main Authors: | , , |
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| Format: | Conference or Workshop Item |
| Language: | English |
| Published: |
2018
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| Subjects: | |
| Online Access: | http://irep.iium.edu.my/63875/ http://irep.iium.edu.my/63875/ http://irep.iium.edu.my/63875/19/63875%20abstract.pdf |
| Summary: | INTRODUCTION:
Treatment of osteomyelitis is still a major
challenge in orthopedics. Study of osteomyelitis
and infection requires the use of suitable animal.
New Zealand white rabbit (NZWR)
(Oryctologus cuniculus) is an acceptable
experimental model. It is used for local delivery
of antibiotics in osteomyelitis treatment as it
mimic the disease process in human. The
objectives of this study are to create
osteomyelitis in rabbit femur and to analyze the
treatment given via biomaterials impregnated
with gentamicin beads.
MATERIALS & METHODS:
Osteomyelitis is induced by inoculation of
Staphylococcus aureus ATCC 25923 into the
drilled distal femur of NZWR. The weights of
the rabbits were weight between 2.5 and 4.2 kg.,
all aged above 6 months old. Thirty-four (34)
NZWR were used during the study. They were
divided into 2 groups (hydroxyapatite(HA) and
calcium sulphate (Ca2SO4) with four subgroups
with 3, 6, 12 and 26 weeks. There are two
surgeries for each NZWR, first to induced
infection and second surgery is to undergo
surgical debridement and biomaterial
impregnated antibiotics implantation. The
response of the treatments (biomaterials
impregnated with gentamicin) against the
infection were evaluated through gross
presentations, radiograph, micro CT,
microbiological and histological results. SPSS
was used to evaluate the results.
RESULTS:
Osteomyelitic changes noted in all rabbit after
inoculation of bacteria. The rabbits’ weights
reduced after 3 weeks of bacteria inoculation.
After the treatment with biomaterial
impregnated antibiotics, they showed significant
increase in weights. Its showed significance
weight difference (p<0.05) at week 12 and 26 in
both groups. The evaluation was done at 3,6,12,
and 26 weeks. The microbiology analysis at 26
weeks of interval showed no bacteria isolated.
The holes at the drilled distal femur of the
NZWR intended for bacteria inoculation was
closed at 12 weeks’ interval. The histological
interpretation, revealed healing of the infected
area with appearance of new bone formation at
weeks 6 to 26. The micro CT results showed
that trebaculae numbers increased significantly
(p>0.05) with the treatment. The biomaterials
containing calcium sulphate was reduce in size
and disappear at week 26. The results show
complete bone healing at 26 weeks of interval.
There is no significant difference (P<0.05)
between the hydroxyapatite impregnated
Gentamycin and Calcium sulphate impregnated
gentamycin in the area of Radiology, histology
and micro CT assessment.
DISCUSSIONS:
Osteomyelitis is difficult to treat because it is
often associated with necrosis of bone and poor
vascular perfusion accompanied by infection of
the surrounding tissues. The treatment of
osteomyelitis mainly involves operative
debridement, surgical removal of necrotic tissue
and antibiotic therapy.The necessity of local
antibiotic therapy as well as surgery has been
recognized and various methods have been
developed for delivering antibiotics. The
antibiotics impregnated biomaterials are shown
to be effective in the treatments of osteomyelitis.
Drug delivery system will help in treatment of
osteomyelitis.
CONCLUSION:
Biomaterial Impregnated gentamicin has great
potential to be utilized as an implanted drug
delivery intended for the treatment of
osteomyelitis. |
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