Burch Marc-Antoine, Keshishian Aron, Wittmann Charlotte, Nehrbass Dirk, Thompson Keith, Arens Daniel, Richards R Geoff, Mdingi Vuysa, Chitto Marco, Morgenstern Mario, Moriarty T Fintan, Eijer Henk
AO Research Institute Davos, 7270 Davos, Switzerland.
Klinik für Orthopädie und Traumatologie, Universitätsspital Basel, 4031 Basel, Switzerland.
Microorganisms. 2024 Jun 1;12(6):1134. doi: 10.3390/microorganisms12061134.
Glucocorticoids may be given prior to major orthopedic surgery to decrease postoperative nausea, vomiting, and pain. Additionally, many orthopedic patients may be on chronic glucocorticoid therapy. The aim of our study was to investigate whether glucocorticoid administration influences Orthopedic-Device-Related Infection (ODRI) in a rat model. Screws colonized with were implanted in the tibia of skeletally mature female Wistar rats. The treated groups received either a single shot of dexamethasone in a short-term risk study, or a daily dose of dexamethasone in a longer-term interference study. In both phases, bone changes in the vicinity of the implant were monitored with microCT. There were no statistically significant differences in bacteriological outcome with or without dexamethasone. In the interference study, new bone formation was statistically higher in the dexamethasone-treated group ( = 0.0005) as revealed by CT and histopathological analysis, although with relatively low direct osseointegration of the implant. In conclusion, dexamethasone does not increase the risk of developing periprosthetic osteolysis or infection in a pre-clinical model of ODRI. Long-term administration of dexamethasone seemed to offer a benefit in terms of new bone formation around the implant, but with low osseointegration.
在进行大型骨科手术前可给予糖皮质激素，以减少术后恶心、呕吐和疼痛。此外，许多骨科患者可能正在接受慢性糖皮质激素治疗。我们研究的目的是调查在大鼠模型中给予糖皮质激素是否会影响骨科器械相关感染（ODRI）。将接种了[具体细菌名称未给出]的螺钉植入骨骼成熟的雌性Wistar大鼠的胫骨中。在短期风险研究中，治疗组接受单次地塞米松注射；在长期干预研究中，治疗组接受每日剂量的地塞米松。在两个阶段中，均使用微型计算机断层扫描（microCT）监测植入物附近的骨骼变化。使用或不使用地塞米松时，细菌学结果无统计学显著差异。在干预研究中，CT和组织病理学分析显示，地塞米松治疗组的新骨形成在统计学上更高（P = 0.0005），尽管植入物的直接骨整合相对较低。总之，在ODRI的临床前模型中，地塞米松不会增加假体周围骨溶解或感染的风险。长期给予地塞米松似乎在植入物周围的新骨形成方面有好处，但骨整合较低。
