Results of using various types of implants in experimental management of long bone osteomyelitic defects

Relevance Chronic osteomyelitis makes about 10 to 25 % in the structure of locomotion system diseases. Moreover, osteomyelitis recurs in 20 to 30 % of the affected patients and results in secondary amputations and limb functional deficiency in 10.3 to 57 % of them. Management of secondary cavities and defects under such conditions is a challenge that does not have a uniform solution to date. Nano-composite carbon materials combine sufficient strength with possible biological integration and seem to be promising materials for filling bone defects of osteomyelitic origin. Purpose To study experimentally the results of using a nano-composite carbon-based material and compare it with allologous bone and porous ceramic implants for filling osteomyelitic long bone defects. Materials and method Experimental studies were performed on 20 normal rabbits. One cortical layer of the anterior shaft surface of their left radius was perforated by drilling. St. Aureus suspension of 0.5 ml in the concentration of 10-5 CFU/ml was injected into the medullary canal. The events of a local inflammatory reaction such as swelling, local hyperemia, temperature elevation, fistula formation were observed by day 7 in all the animals. Necrosequestrectomy was performed two weeks later. A standard defect of 0.5-cm was filled in with three different materials. A carbon nanostructured implant, a ceramic implant and allogenic bone bio-implant were used. Results X-ray and biomechanical studies during the experiment found that the use of the carbon implant for filling osteomyelitic defects provided optimization of bone tissue regeneration as compared with the use of allogenic bone and ceramic implants. Complete consolidation and formation of a block at the implant to bone border occurred by the end of week 4. Radiographic borders between the bone and the nano-carbon implant disappeared by week 6. The results of the biomechanical study revealed the comparable parameters of the breaking force in Group 1 and the control group of normal animals but a significant reduction in breaking force in Groups 2 and 3. Conclusion The use of nano-structured carbon material for filling osteomyelitic defects accelerated regenerated bone formation and provided positive osseointegration at the bone-to-implant border when compared with the other bone-substitute materials studied.