THE USE OF ENDOTHELIAL PROGENITOR CELLS (EPCS) AND LOCAL ANTIBIOTICS FOR THE TREATMENT OF INFECTED NONUNIONS IN A SMALL ANIMAL MODEL
Notice bibliographique
Résumé
The purpose of this study was to assess the efficacy of Endothelial Progenitor Cell-based therapy (EPC) in the presence and absence of local antibiotics (ABX) in the treatment of infected nonunions in a small animal model. We hypothesized that EPC therapy would promote bone healing and eradicate infection, and that the addition of local antibiotics would further facilitate these outcomes. A 5-mm segmental defect was created and stabilized with mini-plate fixation in the right femur of Fischer 344 rats. A control solution (Experiment 1: non-contaminated arm) or an inoculum of Staphylococcus epidermidis (Experiment 2: contaminated arm) was delivered at the defect site on a gelatin scaffold. Fourteen days later, a second surgery was performed and one of the following treatments was applied in both the non-contaminated and contaminated arms, creating a total of seven groups: 1) control (no treatment), 2) EPC, 3) EPC + ABX (local vancomycin and rifampin), and 4) ABX (only in the contaminated arm). Biweekly radiographs were obtained to monitor bone healing and infection. All animals were euthanized 10 weeks after the second surgery. Soft tissue and fixation material samples were collected and processed for microbiological analysis. The radiographs were scored and assessed blindly for union status, defect filling, and infection. Bone healing was also assessed with micro-CT and biomechanics following specimen harvest. Our primary outcome for Experiment 2 was the rate of non-infected union. Experiment 1: Non-contaminated: All animals in the EPC and EPC+ABX groups demonstrated significantly improved healing relative to controls with regards to union rates. Similarly radiographic scores, micro-CT (bone volume (BV) and bone volume fraction (BV/TV)), and biomechanics (torque and stiffness) all demonstrated significantly improved outcomes in the EPC and EPC+ABX compared to the control group. There were no significant differences between the EPC and EPC+ABX groups (Table 1). Experiment 2: Contaminated: Animals that received EPC+ABX or ABX alone demonstrated high rates of infection eradication compared to the EPC only and control groups (Table 2). The EPC groups (EPC only and EPC+ABX) demonstrated improved bone healing outcomes relative to control and ABX alone groups. A post-hoc analysis test comparing rates of non-infected union showed that the EPC+ABX group had a significantly higher rate of non-infected union compared to ABX alone and control group (p=0.003). These results demonstrate several important findings. First, the use of local ABX (vancomycin and rifampin) alone or in combination with EPCs is highly effective at eradicating infection in a small animal model of infected nonunion. Second, combining local ABX with EPCs does not negatively impact the fracture-healing efficacy of EPCs. Finally, the combined treatment of infected nonunions with EPCs and local ABX significantly improved both infection and healing rates. These results support the continued investigation of EPCs and local ABX as a potential single-stage treatment for infected nonunions. For any figures or tables, please contact the authors directly.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».