Animal Models for Fracture-Related Infections: A Systematic Review
Journal Title: Journal of Orthopaedic Science and Research - Year 2024, Vol 5, Issue 3
Abstract
Background: Fracture-Related Infections (FRIs) are among the most challenging complications in orthopaedics. The incidence of these infections is high, particularly in complex, open fractures. FRI management typically involves irrigation and debridement of the fracture site, implant exchange and prolonged antibiotic therapy. This regimen is often ineffective resulting in poor patient outcomes and inefficient use of healthcare resources. As such, improved diagnostic, preventative and therapeutic interventions are needed. To effectively address these gaps, valid preclinical animal models that accurately replicate clinical FRIs are required. The purpose of this systematic review was to synthesize the relevant peer-reviewed literature related to FRI animal models to analyze their translational rigor and potential. Methods: An online database search was conducted using PubMed in which 77 articles were eligible for inclusion in this review. Results: Data extraction revealed a wide spectrum of animal species, methods for bone defect creation and fixation, bacterial inoculum deliveries and doses and intervention time points among the studies. Further, clinical, radiographic, microbiologic and histologic outcomes of infected control groups were assessed to determine validity of each model. Importantly, FRI-defining features such as bacterial biofilms and delayed fracture union were only reported in 20.8% and 29.9% of models, respectively. Conclusion: While it is challenging to incorporate and validate all clinically relevant components of FRIs into an animal model, many of the gaps identified in this systematic review can and should be addressed to improve the efficacy of preclinical evidence aimed at advancing FRI management.
Authors and Affiliations
Bryce W Rigden1,2, Aaron M Stoker1,2, Chantelle C Bozynski1,2, Kyle Schweser1,2, James P Stannard1,2, James L Cook1,2*
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