Department of Orthopaedics, University Medical Center Utrecht, Heidelberglaan 100, 3508 GA, Utrecht, The Netherlands.
J Orthop Res. 2019 Oct;37(10):2067-2076. doi: 10.1002/jor.24422. Epub 2019 Aug 11.
The clinical impact of bacterial infections on bone regeneration has been incompletely quantified and documented. As a result, controversy exists about the optimal treatment strategy to maximize healing of a contaminated defect. Animal models are extremely useful in this respect, as they can elucidate how a bacterial burden influences quantitative healing of various types of defects relative to non-infected controls. Moreover, they may demonstrate how antibacterial treatment and/or bone grafting techniques facilitate the osteogenic response in the harsh environment of a bacterial infection. Finally, it a well-known contradiction that osteomyelitis is characterized by uncontrolled bone remodeling and bone loss, but at the same time, it can be associated with excessive new bone apposition. Animal studies can provide a better understanding of how osteolytic and osteogenic responses are related to each other during infection. This review discusses the in vivo impact of bacterial infection on osteogenesis by addressing the following questions (i) How does osteomyelitis affect the radiographic bone appearance? (ii) What is the influence of bacterial infection on histological bone healing? (iii) How do bacterial infections affect quantitative bone healing? (iv) What is the effect of antibacterial treatment on the healing outcome during infection? (v) What is the efficacy of osteoinductive proteins in infected bones? (vi) What is the balance between the osteoclastic and osteoblastic response during bacterial infections? (vii) What is the mechanism of the observed pro-osteogenic response as observed in osteomyelitis? © 2019 The Authors. Journal of Orthopaedic Research published by Wiley Periodicals, Inc. on behalf of Orthopaedic Research Society. J Orthop Res 37:2067-2076, 2019.
细菌感染对骨再生的临床影响尚未得到充分量化和记录。因此，关于最大限度地提高污染缺陷愈合的最佳治疗策略存在争议。在这方面，动物模型非常有用，因为它们可以阐明细菌负荷如何影响各种类型的缺陷相对于未感染对照的定量愈合。此外，它们可以证明抗菌治疗和/或骨移植技术如何在细菌感染的恶劣环境中促进成骨反应。最后，众所周知的矛盾是骨髓炎的特征是不受控制的骨重塑和骨质流失，但同时它也可能与过多的新骨附着有关。动物研究可以更好地了解在感染过程中溶骨性和成骨性反应是如何相互关联的。本综述通过回答以下问题讨论了细菌感染对成骨的体内影响：（i）骨髓炎如何影响射线照相的骨外观？（ii）细菌感染对组织学骨愈合的影响是什么？（iii）细菌感染如何影响定量骨愈合？（iv）在感染过程中，抗菌治疗对愈合结果有什么影响？（v）感染骨中骨诱导蛋白的疗效如何？（vi）在细菌感染期间，破骨细胞和成骨细胞反应之间的平衡如何？（vii）在骨髓炎中观察到的促成骨反应的机制是什么？© 2019 作者。由 Wiley 期刊出版公司代表骨科研究协会出版的《骨科研究杂志》。J Orthop Res 37:2067-2076, 2019。
