PDF(Pubmed)
Abstract：
Glucocorticoids may be given prior to major orthopedic surgery to decrease postoperative nausea, vomiting, and pain. Additionally, many orthopedic patients may be on chronic glucocorticoid therapy. The aim of our study was to investigate whether glucocorticoid administration influences Orthopedic-Device-Related Infection (ODRI) in a rat model. Screws colonized with Staphylococcus epidermidis were implanted in the tibia of skeletally mature female Wistar rats. The treated groups received either a single shot of dexamethasone in a short-term risk study, or a daily dose of dexamethasone in a longer-term interference study. In both phases, bone changes in the vicinity of the implant were monitored with microCT. There were no statistically significant differences in bacteriological outcome with or without dexamethasone. In the interference study, new bone formation was statistically higher in the dexamethasone-treated group (p = 0.0005) as revealed by CT and histopathological analysis, although with relatively low direct osseointegration of the implant. In conclusion, dexamethasone does not increase the risk of developing periprosthetic osteolysis or infection in a pre-clinical model of ODRI. Long-term administration of dexamethasone seemed to offer a benefit in terms of new bone formation around the implant, but with low osseointegration.
摘要：
可以在骨科大手术前给予糖皮质激素，以减少术后恶心，呕吐,和痛苦。此外,许多骨科患者可能正在接受慢性糖皮质激素治疗。我们研究的目的是研究糖皮质激素给药是否会影响大鼠模型中的骨科设备相关感染（ODRI）。将定植有表皮葡萄球菌的螺钉植入骨骼成熟的雌性Wistar大鼠的胫骨中。在短期风险研究中，治疗组接受了单次地塞米松注射，或长期干扰研究中每日剂量的地塞米松。在这两个阶段,用microCT监测植入物附近的骨变化.有或没有地塞米松的细菌学结果没有统计学上的显着差异。在干扰研究中，CT和组织病理学分析显示，地塞米松治疗组的新骨形成在统计学上更高（p=0.0005），尽管植入物的直接骨整合相对较低。总之,在ODRI的临床前模型中,地塞米松不会增加发生假体周围骨质溶解或感染的风险.长期服用地塞米松似乎对植入物周围的新骨形成有益。但骨整合低。
