Alper KURTOĞLU, Murat OTO, Ahmet Esat KITER

Enfekte Diz Protez Modelinde İntraartiküler Ozon Tedavisi

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:

Ozon; Protez ve İmplant; Enfeksiyon; Antibakterial Ajanlar

Intra-articular Ozone Treatment of Infection in a Knee Prosthesis Model

AbstractObjectives: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.

Keywords:

Ozone; Prostheses and Implants; Knee Infection; Ant-bacterial Agents,

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