Development of a fracture osteomyelitis model in the rat femur.

Osteomyelitis contributes significantly to fracture morbidity. Our objective was to develop a model of induced implant-associated osteomyelitis following fracture repair by modifying an existing rat femur fracture model. Thirty male Sprague-Dawley rats were divided into three groups (Control, Staphylococcus aureus, S. aureus + ceftriaxone). The closed femur fracture model (right femur), stabilized with an intramedullary pin, was combined with inoculation of 10(4) colony-forming units (CFU) of S. aureus. Radiographs were obtained immediately after surgery and at weeks 1, 2, and 3 and were evaluated by individuals blinded to treatment group. At necropsy the CFU of S. aureus per femur and pin were determined and synovial tissue and blood were cultured. The fractured femur from two rats in each group was evaluated histologically. A statistically significant difference in the CFU/femur and CFU/pin was found across treatment groups, with the highest CFU in the S. aureus group and the lowest in the Control group. Cultures of synovial tissue were positive in 11/19 of inoculated limbs. Osteomyelitis was present both radiographically and histopathologically in both S. aureus groups but not in the controls. No rats were systemically ill or had positive blood cultures at the study endpoint. This model will be useful for the evaluation of treatments or prophylactics designed for use in implant-associated osteomyelitis.