Evaluation of the effect of vitamin E doped UHMWPE on biofilm development and infection using an in vivo experimental model

The aim of our study was the evaluation of an in vivo experimental model of implant-related septic arthritis. 5 x 10 mm strips out of a polyethylene sheet 500 microns thick were incubated with a 0.5 McFarland bacterial suspension of collection strains S. aureus and S. epidermidis. A surgical experimental model was prepared, implanting the samples in the subquadricipital articular space of the rabbit's knee. After 7 days of survival, the knee joint was opened wide through the previous surgical approach and the polyethylene sample was retrieved. The UHMWPE samples were processed following a sonication and quantification protocol. Ten rabbits for each species were studied, five with each material. Negative controls (UHMWPE strips without attached bacteria) were also implanted in contralateral knees. S. aureus colonies were detected only in three rabbits with non-treated UHMWPE and in two with vitamin E-doped UHMWPE. No differences in colony counts were observed for S. aureus. No growth was detected for S. epidermidis, although clinical signs of infection were detected in all animals with inoculated samples. The model was useful to evaluate the effect of modifications in biomaterials, although highly pathogenic bacteria are needed to obtain quantifiable data.