Comprehensive evaluation of copper-coated intraosseous structures implantation in experimental conditions with deep gram-negative hip infection in animals

Introduction: The resistance of pathogenic microorganisms to antibacterial therapy in cases of periprosthetic infection is the cause of the chronic course and the inability to stop the inflammatory process. The use of antibacterial coated implants opens up new opportunities for the prevention and effective treatment of postoperative complications of an infectious nature during operations using non-biotic implants.

Purpose. To carry out a comprehensive assessment of clinical and paraclinical indicators in animals with modeled gram-negative periimplant infection of the femur using intramedullary titanium rods without coating and with copper-containing coating based on amorphous nanocarbon.

Materials and methods. The research material included indicators of the severity of disorders of static-dynamic function, the severity of local signs of inflammation, the dynamics of animal body weight, as well as the pathomorphological picture of the disease course of two compared groups of animals (each group included 16 individuals) with a model of periimplant deep hip infection with an etiotropic agent in the form of a museum strain of P. aeruginosa. The evaluation of treatment outcomes took into account the sum of criteria. The criterion was expressed in scores from 0 to 4. In experimental operations, intramedullary titanium alloy implants were used without coating (control group) and coated with amorphous nanocarbon containing microparticles of copper in a certain concentration (main group). The studies were conducted on days 3, 7, 14, and 28. Clinical, electron microscopic, radiation and statistical research methods were used.

Results. It has been revealed that the use of innovative copper-coated implants for gram-negative osteomyelitis of the femur in laboratory rats achieves optimal treatment results in the absence of physical inactivity, weight loss, extensive osteolysis and an array of necrotic tissues. The total assessment of the result in animals of the control group was 11.7 points (unsatisfactory outcome), in the main group — 4.7 points (good result). Statistical calculation of the difference determined their significant reliable difference (t=11.32; df=30, p=0.01).

Conclusions. A comprehensive study of the inflammatory response when using coated implants based on amorphous nanocarbon with copper particles in conditions of experimental gram-negative infection allows us to consider this type of implant as a promising tool for solving the problems of treatment and prevention of periprosthetic infection and osteomyelitis in clinical practice.

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