[Implant-associated post-traumatic osteomyelitis. Bacterial biofilms and the immune defence as protagonists of the local inflammatory process].
BACKGROUND
Formation of bacterial biofilms on implants is a severe complication following orthopaedic surgery. In the present study we addressed the role of the immune response, particularly with regard to the pathogenesis of the disease.


METHODS
In a prospective study comprising 74 patients with implant-associated post-traumatic osteomyelitis, peripheral blood cells as well as cells recovered from the infected site during surgery were characterised phenotypically and functionally.


RESULTS
We found massive infiltration of polymorphonuclear neutrophils (PMN), which were highly activated, particularly regarding their bactericidal potential, such as increased production of superoxides and upregulation of activation-associated surface receptors.


CONCLUSIONS
PMN are activated in response to the implant-associated osteomyelitis; they also infiltrate the infected tissue, but cannot control the infection. By release of their cytotoxic entities they could contribute to tissue destruction and eventually to osteolysis.
Wagner
C
C
Klinik für Unfall- und Wiederherstellungschirurgie, Berufsgenossenschaftliche Unfallklinik, Ludwig-Guttmann-Strasse 13, 67071 Ludwigshafen, Deutschland. christof.wagner@urz.uni-heidelberg.de
Hänsch
G M
GM
Wentzensen
A
A
Heppert
V
V
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018441:Biofilms; D001858:Bone Nails / Q000009:adverse effects; D002633:Chemotaxis; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007249:Inflammation / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000276:immunology / Q000502:physiology*; D009984:Orthopedic Fixation Devices / Q000009:adverse effects*; D010000:Osteitis / Q000209:etiology / Q000276:immunology; D010014:Osteolysis / Q000209:etiology / Q000276:immunology; D010019:Osteomyelitis / Q000209:etiology* / Q000276:immunology*; D010641:Phenotype; D011446:Prospective Studies; D016459:Prosthesis-Related Infections / Q000209:etiology / Q000276:immunology