Albuquerque João Bourbon de, Della Rocca Gregory J, Stoker Aaron M, Bozynski Chantelle C, Sullentrup Anna, Gull Tamara, Cook James L, Nuelle Julia A V
Thompson Laboratory for Regenerative Orthopaedics & Missouri Orthopaedic Institute, University of Missouri, Columbia, MO, USA.
Veterinary Medical Diagnostic Laboratory, University of Missouri, Columbia, MO, USA.
J Orthop. 2024 Oct 2;61:92-96. doi: 10.1016/j.jor.2024.09.019. eCollection 2025 Mar.
Open articular fractures often include contaminated, devascularized osteoarticular fragments that are critical for joint reconstruction. Definitive treatment is often delayed such that decontamination and preservation of critical fragments for joint reconstruction is highly desirable. To validate decontamination and preservation protocols for safe and effective preservation of osteoarticular fragments for re-implantation, a preclinical animal model for inducing type 3 open articular fractures with contaminated, devascularized osteoarticular fragments was developed and validated.
With IACUC approval, purpose-bred hounds (n = 5) were humanely euthanized. Immediately following euthanasia, a penetrating captive bolt pistol with 1.25 grain cartridge centered on the cranial aspect of each distal humerus was discharged to create open fractures in 3 dogs (6 elbows). In 2 dogs, matched osteoarticular tissues from non-injured elbows (controls) were retrieved for comparison. Distal humerus, proximal radius, and proximal ulna osteoarticular fragments (n = 27) were immediately placed in Missouri Osteochondral Preservation System (MOPS) solution and stored at room temperature. Radiographic, chondrocyte viability, and quantitative microbial culture assessments were performed immediately (time-0) and at 7 and 14 days of storage.
This preclinical canine model reliably produced type 3 open distal humeral fractures characterized by devascularized and contaminated osteoarticular fracture fragments. All fragments produced extensive microbial growth through 14 days of storage. Without decontamination, viable chondrocyte density in the fragments decreased significantly within 7 days, likely attributable to the profound contamination.
These data highlight the importance of developing a reliable method for point-of-care decontamination and preservation of osteoarticular fracture fragments for safe and effective reimplantation of articular fracture fragments for joint reconstruction.
开放性关节骨折通常包含受污染、血运受损的骨关节碎片，这些碎片对关节重建至关重要。确定性治疗往往会延迟，因此非常希望能对关键碎片进行去污处理并保存以用于关节重建。为了验证用于安全有效保存骨关节碎片以便重新植入的去污和保存方案，开发并验证了一种用于诱导伴有受污染、血运受损骨关节碎片的3型开放性关节骨折的临床前动物模型。
在获得机构动物护理和使用委员会（IACUC）批准后，对专门饲养的猎犬（n = 5）实施安乐死。安乐死后立即使用装有1.25格令弹药筒的穿透式栓式手枪，以每只肱骨远端的颅侧为中心开枪，在3只犬（6个肘部）中造成开放性骨折。在2只犬中，取出未受伤肘部的匹配骨关节组织（对照组）用于比较。将肱骨远端、桡骨近端和尺骨近端的骨关节碎片（n = 27）立即放入密苏里骨软骨保存系统（MOPS）溶液中，并在室温下储存。在储存的即刻（0时）以及7天和14天时进行影像学、软骨细胞活力和定量微生物培养评估。
这种临床前犬模型可靠地产生了3型开放性肱骨远端骨折，其特征为血运受损和受污染的骨关节骨折碎片。在储存14天内，所有碎片均出现大量微生物生长。未经去污处理，碎片中存活软骨细胞密度在7天内显著下降，这可能归因于严重污染。
这些数据突出了开发一种可靠方法用于现场去污和保存骨关节骨折碎片的重要性，以便安全有效地重新植入关节骨折碎片以进行关节重建。
