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Histological score for degrees of severity in an implant-associated infection model in mice

  • Trauma Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Several scores were introduced to diagnose and to classify osteomyelitis in practice. Mouse models are often used to study the pathophysiology of bone infection and to test therapeutic strategies. Aim of the present study was to design a score to diagnose and quantify implant-associated infection in a murine experimental model.

Materials and methods

Four independent parameters were developed: existence of callus, consolidation of the fracture, structural changes of the medullary cavity and number of bacteria. The score was assessed in a standardized implant-associated mouse model with 35 BALB/c-mice. The left femur was osteotomized, fixed by a titanium locking plate and infection was induced by inoculation of Staphylococcus aureus into the fracture gap. For the sham group, the procedure was performed without inoculation of bacteria. The score was assessed on days 7, 14 and 28. Each item of the score showed lower values for the infection group compared to the controls after 4 weeks.

Results

Regardless of the assessed time point, the overall total score was significantly higher in the control group compared to the infection group (p < 0.0001). Analysis revealed a sensitivity of 0.85, specificity of 1.0, negative predictive value of 0.67 and positive predictive value of 1.0.

Conclusion

The proposed score assessing severity of fracture-related infection in an implant-associated murine model was easy to access, feasible to diagnose and estimate bone healing and infection in a murine bone infection with a high sensitivity. Therefore, this score might be a useful tool to quantify infection-related changes after fracture in further future preclinical studies.

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Acknowledgements

We thank Prof. Dr. H. E. Gabbert and the Institute for Pathology and Prof. Dr. C. R. MacKenzie and the Institute for Medical Microbiology at the Heinrich-Heine-University for valuable advice. All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

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Author notes

  1. Michael Hambüchen

    Present address: Department for Plastic and Aesthetic Surgery, Florence-Nightingale Hospital, Kreuzbergstraße 79, 40489, Düsseldorf, Germany

  2. Tim Lögters

    Present address: Department of Trauma-, Hand- and Orthopedic Surgery, St. Antonius Hospital Cologne, Schillerstraße 23, 50968, Cologne, Germany

  3. Carina Büren and Michael Hambüchen contributed equally.

Authors and Affiliations

  1. Department for Trauma- and Hand Surgery, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany

    Carina Büren, Joachim Windolf & Ceylan Daniela Windolf

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  1. Carina Büren
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  2. Michael Hambüchen
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  3. Joachim Windolf
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  4. Tim Lögters
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  5. Ceylan Daniela Windolf
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Contributions

All authors have read and approved the final submitted manuscript. CB: literature search, study design, data collection, data analysis, data interpretation and writing. MH: study design, data collection, data analysis, data interpretation. TL and CDW: study design, data collection, data analysis, data interpretation and critical revision. JW: critical revision.

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Correspondence to Carina Büren.

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All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

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Büren, C., Hambüchen, M., Windolf, J. et al. Histological score for degrees of severity in an implant-associated infection model in mice. Arch Orthop Trauma Surg 139, 1235–1244 (2019). https://doi.org/10.1007/s00402-019-03188-6

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  • DOI: https://doi.org/10.1007/s00402-019-03188-6

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