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.