Early implant-associated osteomyelitis results in a peri-implanted bacterial reservoir

Louise Kruse Jensen, Janne Koch, Bent Aalbaek, Arshnee Moodley, Thomas Bjarnsholt, Kasper Nørskov Kragh, Andreas Petersen, Henrik Elvang Jensen

27 Citationer (Scopus)


Implant-associated osteomyelitis (IAO) is a common complication in orthopedic surgery. The aim of this study was to elucidate how deep IAO can go into the peri-implanted bone tissue within a week. The study was performed in a porcine model of IAO. A small steel implant and either 10(4) CFU/kg body weight of Staphylococcus aureus or saline was inserted into the right tibial bone of 12 pigs. The animals were consecutively killed on day 2, 4 and 6 following implantation. Bone tissue around the implant was histologically evaluated. Identification of S. aureus was performed immunohistochemically on tissue section and with scanning electron microscopy and peptide nucleic acid in situ hybridization on implants. The distance of the peri-implanted pathological bone area (PIBA), measured perpendicular to the implant, was significantly larger in infected animals compared to controls (p = 0.0014). The largest differences were seen after 4 and 6 days of inoculation, where PIBA measurements of up to 6 mm were observed. Positive S. aureus bacteria were identified on implants and from 25 μm to 6 mm into PIBA. This is important knowledge for optimizing outcomes of surgical debridement in osteomyelitis.

TidsskriftAPMIS : acta pathologica, microbiologica, et immunologica Scandinavica
Udgave nummer1
Sider (fra-til)38-45
Antal sider8
StatusUdgivet - jan. 2017


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