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Influence of staphylococcus epidermidis biofilm on the mechanical strength of soft tissue allograft

Influence of staphylococcus epidermidis biofilm on the mechanical strength of soft tissue allograft
Influence of staphylococcus epidermidis biofilm on the mechanical strength of soft tissue allograft
We sought to determine the impact of bacterial inoculation and length of exposure on the mechanical integrity of soft tissue tendon grafts. Cultures of Staphylococcus epidermidis were inoculated on human tibialis posterior cadaveric tendon to grow biofilms. A low inoculum in 10% growth medium was incubated for 30 min to replicate conditions of clinical infection. Growth conditions assessed included inoculum concentrations of 100, 1000, 10,000 colony-forming units (CFUs). Tests using the MTS Bionix system were performed to assess the influence of bacterial biofilms on tendon strength. Load-to-failure testing was performed on the tendons, and the ultimate tensile strength was obtained from the maximal force and the cross-sectional area. Displacements of tendon origin to maximal displacement were normalized to tendon length to obtain strain values. Tendon force-displacement and stress-strain relationships were calculated, and Young's modulus was determined. Elastic modulus and ultimate tensile strength decreased with increasing bioburden. Young's modulus was greater in uninoculated controls compared to tendons inoculated at 10,000 CFU (p = 0.0011) but unaffected by bacterial concentrations of 100 and 1000 CFU (p = 0.054, p = 0.078). Increasing bioburden was associated with decreased peak load to failure (p = 0.043) but was most significant compared to the control under the 10,000 and 1000 CFU growth conditions (p = 0.0005, p = 0.049). The presence of S. epidermidis increased elasticity and decreased ultimate tensile stress of human cadaveric tendons, with increasing effect noted with increasing bioburden.
ACL reconstruction, Staphylococcus epidermis, graft failure, infection
0736-0266
1 - 7
Sorensen, Hannah
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Magnussen, Robert A.
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DiBartola, Alex C.
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Mallory, Noah
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Litsky, Alan S.
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Stoodley, Paul
08614665-92a9-4466-806e-20c6daeb483f
Swinehart, Steven
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Duerr, Robert
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Kaeding, Christopher
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Flanigan, David C.
80377c20-800e-47cf-bf9b-22dcd861013c
Sorensen, Hannah
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Magnussen, Robert A.
2b3e3248-1ff7-4faa-9524-49931ab33f89
DiBartola, Alex C.
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Mallory, Noah
511202a9-a2bc-42ce-9e6c-d61a8393ed3c
Litsky, Alan S.
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Stoodley, Paul
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Swinehart, Steven
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Duerr, Robert
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Kaeding, Christopher
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Flanigan, David C.
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Sorensen, Hannah, Magnussen, Robert A., DiBartola, Alex C., Mallory, Noah, Litsky, Alan S., Stoodley, Paul, Swinehart, Steven, Duerr, Robert, Kaeding, Christopher and Flanigan, David C. (2022) Influence of staphylococcus epidermidis biofilm on the mechanical strength of soft tissue allograft. Journal of Orthopaedic Research, 1 - 7. (doi:10.1002/jor.25360). (In Press)

Record type: Article

Abstract

We sought to determine the impact of bacterial inoculation and length of exposure on the mechanical integrity of soft tissue tendon grafts. Cultures of Staphylococcus epidermidis were inoculated on human tibialis posterior cadaveric tendon to grow biofilms. A low inoculum in 10% growth medium was incubated for 30 min to replicate conditions of clinical infection. Growth conditions assessed included inoculum concentrations of 100, 1000, 10,000 colony-forming units (CFUs). Tests using the MTS Bionix system were performed to assess the influence of bacterial biofilms on tendon strength. Load-to-failure testing was performed on the tendons, and the ultimate tensile strength was obtained from the maximal force and the cross-sectional area. Displacements of tendon origin to maximal displacement were normalized to tendon length to obtain strain values. Tendon force-displacement and stress-strain relationships were calculated, and Young's modulus was determined. Elastic modulus and ultimate tensile strength decreased with increasing bioburden. Young's modulus was greater in uninoculated controls compared to tendons inoculated at 10,000 CFU (p = 0.0011) but unaffected by bacterial concentrations of 100 and 1000 CFU (p = 0.054, p = 0.078). Increasing bioburden was associated with decreased peak load to failure (p = 0.043) but was most significant compared to the control under the 10,000 and 1000 CFU growth conditions (p = 0.0005, p = 0.049). The presence of S. epidermidis increased elasticity and decreased ultimate tensile stress of human cadaveric tendons, with increasing effect noted with increasing bioburden.

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Journal Orthopaedic Research - 2022 - Sorensen - Influence of Staphylococcus epidermidis biofilm on the mechanical strength - Version of Record
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Accepted/In Press date: 5 May 2022
Keywords: ACL reconstruction, Staphylococcus epidermis, graft failure, infection

Identifiers

Local EPrints ID: 457518
URI: http://eprints.soton.ac.uk/id/eprint/457518
ISSN: 0736-0266
PURE UUID: 8d536199-fde0-4f1f-bb73-c7e87644c020
ORCID for Paul Stoodley: ORCID iD orcid.org/0000-0001-6069-273X

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Date deposited: 09 Jun 2022 17:35
Last modified: 16 Nov 2022 02:39

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Contributors

Author: Hannah Sorensen
Author: Robert A. Magnussen
Author: Alex C. DiBartola
Author: Noah Mallory
Author: Alan S. Litsky
Author: Paul Stoodley ORCID iD
Author: Steven Swinehart
Author: Robert Duerr
Author: Christopher Kaeding
Author: David C. Flanigan

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