Öz
Amaç:Tavşanda enfekte diz protezi modelinde ozon ve antibiotik kombinasyonunun etkisini araştırmak.
Gereç ve Yöntemler:24 Yeni Zelanda tavşanın sağ femoral kondiline polietilen pul ve vida yerleştirildi ve intraartiküler Staphylococcus aureus inoküle edildi. Dört grup incelendi: kontrol, antibiotik (14 gün), ozon (iki hafta boyunca haftada üç kez), ozon+antibiotik. Cerrahi sonrası yedinci günde tüm tavşanlar klinik olarak incelendi ve dizleri NaCI solüsyonu ile irrige edildi. Her gruptan 2 hayvan rastgele seçildi ve infeksiyon belirlendi. Tüm hayvanlar 3. hafta sonunda sakrifiye edildi. Tüm hayvanlardan diz örnekleri alındı, kültür ekimi yapıldı ve histolojik ve histokimyasal olarak Salter scorlama sistemi ile değerlendirildi.
Bulgular: Kontrol grubu ile diğer gruplar arasında histolojik-histokimyasal skor ve mikrobiolojik olarak anlamlı fark bulundu fakat diğer gruplar arasınsa fark yoktu. İstatistiki olarak önemli olmasada histolojik-histokimyasal sonuç ozon+antibiotik grubunda en düşüktü ve kültür sonucu en iyi antibiotik grubundaydı.
Sonuç: Ozon tedavisi, eklem içi implant bulunan kişilerde enfeksiyonun neden olduğu eklem dejenerasyonunun önlenmesi için alternatif bir seçenek olarak düşünülebilir.
Anahtar Kelimeler
Kaynakça
- References1. Kurtz SM, Lau E, Watson H, Schmier JK, Parvizi J. Economic burden of periprosthetic joint infection in the United States. J. Arthroplasty. 2012;27(8) Suppl.:61–5.e1.2. Sukur E, Akar A, Topcu HN, Cicekli O, Kochai A, Turker M. The effect of N-acetylcysteine on mechanical fatigue resistance of antibiotic-loaded bone cement. J Orthop Surg Res. 2018 May 31;13(1):132.3.Siqueira MB, Saleh A, Klika AK, O’Rourke C, Schmitt S, Higuera CA, et al. Chronic suppression of periprosthetic joint infections with oral antibiotics increases infection-free survivorship. J Bone Joint Surg Am 2015;97:1220–32. 4.Parvizi J, Adeli B, Zmistowski B, Restrepo C, Greenwald AS. Management of periprosthetic joint infection: the current knowledge: AAOS exhibit selection. J Bone Joint Surg Am 2012;94:e104. 5.Koyonos L, Zmistowski B, Della Valle CJ, Parvizi J. Infection control rate of irrigation and debridement for periprosthetic joint infection. Clin. Orthop. Relat. Res. 2011;469:3043–8. 6.Nogales CG, Ferrari PH, Kantorovich EO, Lage-Marques JL. Ozone therapy in medicine and dentistry. J Contemp Dent Pract. 2008;9(4):75-84.7.Al-Saadi H, Potapova I, Rochford ET, Moriarty TF, Messmer P. Ozonated saline shows activity against planktonic and biofilm growing Staphylococcus aureus in vitro: A potential irrigant for infected wounds. Int Wound J. 2016;13:936–942. 8.Hernandez FA. To what extent does ozone therapy need a real biochemical control system? Assessment and importance of oxidative stress. Arch Med Res. 2007;38(5):571-8.9.Guven A, Gundogdu G, Sadir S, Topal T, Erdogan E, Korkmaz A, et al. The efficacy of ozone therapy in experimental caustic esophageal burn. J Pediatr Surg. 2008;43:1679–84.10.Vailant JD, Fraga A, Diaz MT, Mallok A, Viebahn-Hansler R, Fahmy Z, et al. Ozone oxidative postconditioning ameliorates joint damage and decreases pro inflammatory cytokine levels and oxidative stress in PG/PS induced arthritis in rats. Eur J Pharmacol. 2013;714:318–324.11.Zhang J, Guan M, Xie C, Luo X, Zhang Q, Xue Y. Increased growth factors play a role in wound healing promoted by noninvasive oxygen-ozone therapy in diabetic patients with foot ulcers. Oxid Med Cell Longev. 2014;2014:273475.12.Bocci V, Borrelli E, Travagli V, Zanardi I. The ozone paradox: ozone is a strong oxidant as well as a medical drug. Med Res Rev. 2009;29:646-82.13.Salter RB, Bell RS, Keeley FW. The protective effect of continous passive motion on living articular cartilage in acute septic arthritis: an experimental investigation in the rabbit. Clin Orthop Relat Res. 1981;159:223-47.14.Masters JP, Smith NA, Foguet P, Reed M, Parsons H, Sprowson AP. A systematic review of the evidence for single stage and two stage revision of infected knee replacement. BMC Musculoskelet Disord. 2013;14:1.15.Corrado A, Donato P, Maccari S, Cecchi R, Spadafina T, Arcidiacono L, et al. Staphylococcus aureus dependent septic arthritis in murine knee joints: local immune response and beneficial effects of vaccination. Sci Rep. 2016;6:3804316.Heß S, Gallert C. Sensitivity of antibiotic resistant and antibiotic susceptible Escherichia coli, Enterococcus and Staphylococcus strains against ozone. J Water Health. 2015;13:1020–1028. 17.Almaz ME, Sönmez IŞ. Ozone therapy in the management and prevention of caries. J Formos Med Assoc. 2015;114:3–11. 18.Manoto SL, Maepa MJ, Motaung SK. Medical ozone therapy as a potential treatment modality for regeneration of damaged articular cartilage in osteoarthritis. Saudi J Biol Sci. 2016;25:672-9.19.Borrelli E, Alexandre A, Iliakis E, Alexandre A, Bocci V. Disc herniation and knee arthritis as chronic oxidative stress diseases: the therapeutic role of oxygen ozone therapy. J Arthritis. 2015;4:161.20.Mishra SK, Pramanik R, Das P, et al. Role of intra-articular ozone in osteo-arthritis of knee for functional and symptomatic improvement. Ind J Phys Med Rehabil. 2011;22(2):65–69
Öz
Abstract
Objectives:To investigate effect of a combination of ozone and antibiotics on the treatment of an infected knee prosthesis in a rabbit model.
Methods: Twenty-four New Zealand rabbits underwent implantation of a polyethylene washer and screw into the lateral condyle of the right femur and intraarticular inoculation with Staphylococcus aureus. Four groups were examined: control, antibiotic (14 days), ozone (thrice weekly for two weeks), ozone+antibiotic. After the 7th day of surgery, all animals were clinically examined and their knees were irrigated with an NaCl solution. In all groups, two animals were chosen randomly and assessed for infection. All animals were sacrificed at the end of the 3rd week. Knee samples were taken from all animals, cultured, and evaluated via the histologic-histochemical Salter scoring system.
Results: There was a significant difference between the control group and all other groups in histologic-histochemical scores, but no other group-wise differences. Although they did not reach statistical significance, the histological-histochemical scores were lowest in the ozone+antibiotic group and the results of culturing most pronounced in the antibiotic group.
Conclusions: Ozone therapy may be considered to be an alternative option for the prevention of joint degeneration cause by infection in individuals with an intraarticular implant.
Anahtar Kelimeler
Ozone; Prostheses and Implants; Knee Infection; Ant-bacterial Agents
Kaynakça
- References1. Kurtz SM, Lau E, Watson H, Schmier JK, Parvizi J. Economic burden of periprosthetic joint infection in the United States. J. Arthroplasty. 2012;27(8) Suppl.:61–5.e1.2. Sukur E, Akar A, Topcu HN, Cicekli O, Kochai A, Turker M. The effect of N-acetylcysteine on mechanical fatigue resistance of antibiotic-loaded bone cement. J Orthop Surg Res. 2018 May 31;13(1):132.3.Siqueira MB, Saleh A, Klika AK, O’Rourke C, Schmitt S, Higuera CA, et al. Chronic suppression of periprosthetic joint infections with oral antibiotics increases infection-free survivorship. J Bone Joint Surg Am 2015;97:1220–32. 4.Parvizi J, Adeli B, Zmistowski B, Restrepo C, Greenwald AS. Management of periprosthetic joint infection: the current knowledge: AAOS exhibit selection. J Bone Joint Surg Am 2012;94:e104. 5.Koyonos L, Zmistowski B, Della Valle CJ, Parvizi J. Infection control rate of irrigation and debridement for periprosthetic joint infection. Clin. Orthop. Relat. Res. 2011;469:3043–8. 6.Nogales CG, Ferrari PH, Kantorovich EO, Lage-Marques JL. Ozone therapy in medicine and dentistry. J Contemp Dent Pract. 2008;9(4):75-84.7.Al-Saadi H, Potapova I, Rochford ET, Moriarty TF, Messmer P. Ozonated saline shows activity against planktonic and biofilm growing Staphylococcus aureus in vitro: A potential irrigant for infected wounds. Int Wound J. 2016;13:936–942. 8.Hernandez FA. To what extent does ozone therapy need a real biochemical control system? Assessment and importance of oxidative stress. Arch Med Res. 2007;38(5):571-8.9.Guven A, Gundogdu G, Sadir S, Topal T, Erdogan E, Korkmaz A, et al. The efficacy of ozone therapy in experimental caustic esophageal burn. J Pediatr Surg. 2008;43:1679–84.10.Vailant JD, Fraga A, Diaz MT, Mallok A, Viebahn-Hansler R, Fahmy Z, et al. Ozone oxidative postconditioning ameliorates joint damage and decreases pro inflammatory cytokine levels and oxidative stress in PG/PS induced arthritis in rats. Eur J Pharmacol. 2013;714:318–324.11.Zhang J, Guan M, Xie C, Luo X, Zhang Q, Xue Y. Increased growth factors play a role in wound healing promoted by noninvasive oxygen-ozone therapy in diabetic patients with foot ulcers. Oxid Med Cell Longev. 2014;2014:273475.12.Bocci V, Borrelli E, Travagli V, Zanardi I. The ozone paradox: ozone is a strong oxidant as well as a medical drug. Med Res Rev. 2009;29:646-82.13.Salter RB, Bell RS, Keeley FW. The protective effect of continous passive motion on living articular cartilage in acute septic arthritis: an experimental investigation in the rabbit. Clin Orthop Relat Res. 1981;159:223-47.14.Masters JP, Smith NA, Foguet P, Reed M, Parsons H, Sprowson AP. A systematic review of the evidence for single stage and two stage revision of infected knee replacement. BMC Musculoskelet Disord. 2013;14:1.15.Corrado A, Donato P, Maccari S, Cecchi R, Spadafina T, Arcidiacono L, et al. Staphylococcus aureus dependent septic arthritis in murine knee joints: local immune response and beneficial effects of vaccination. Sci Rep. 2016;6:3804316.Heß S, Gallert C. Sensitivity of antibiotic resistant and antibiotic susceptible Escherichia coli, Enterococcus and Staphylococcus strains against ozone. J Water Health. 2015;13:1020–1028. 17.Almaz ME, Sönmez IŞ. Ozone therapy in the management and prevention of caries. J Formos Med Assoc. 2015;114:3–11. 18.Manoto SL, Maepa MJ, Motaung SK. Medical ozone therapy as a potential treatment modality for regeneration of damaged articular cartilage in osteoarthritis. Saudi J Biol Sci. 2016;25:672-9.19.Borrelli E, Alexandre A, Iliakis E, Alexandre A, Bocci V. Disc herniation and knee arthritis as chronic oxidative stress diseases: the therapeutic role of oxygen ozone therapy. J Arthritis. 2015;4:161.20.Mishra SK, Pramanik R, Das P, et al. Role of intra-articular ozone in osteo-arthritis of knee for functional and symptomatic improvement. Ind J Phys Med Rehabil. 2011;22(2):65–69
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Makaleler |
| Yazarlar | |
| Yayımlanma Tarihi | 16 Eylül 2019 |
| Gönderilme Tarihi | 28 Nisan 2019 |
| Yayımlandığı Sayı | Yıl 2019 Cilt: 9 Sayı: 3 |
SMJ'de yayınlanan makaleler, Creative Commons Atıf-GayriTicari 4.0 Uluslararası Lisansı kapsamında lisanslanır