Change of acute stage reactants level in experimental intramedullary osteosynthesis

Aim. To assess the plasma protein fractions as organism’s reaction to osteosynthesis by medical devices made of medical steel and of medical steel coated by titanium and gafnium nitrides mixture. Methods. Diaphyseal tibial fracture was modeled on 30 rabbits with further assessment of animal organism reaction to osteosynthesis by pins made of medical steel and of medical steel coated by super-hard metal nitrides mixture. The change of blood plasma protein fractions and acute phase reactants was used as an indicator. Measurements were performed before the osteosynthesis and on the 5th and 180th day after the surgery. Results. Together with the stable level of total blood protein, dysproteinemia characteristic for acute phase of the inflammation was observed after the trauma and reparatory process induction. Two-waived reaction was registered. The first developed at the 5th day after the surgery and was characterized by the drop of blood albumin level together with α- and β2-globulin levels increase, the reaction was observed in the intervention group earlier compared to control group. The second wave developed at the 180th day and was characterized by β2- and γ-globulin levels increase. The registered changes corresponded with the phases of acute non-specific response, which includes the overproduction of «positive» and decreased production of «negative» acute phase reactants by liver, influenced by cytokines, as well as later adaptive immune response. Conclusion. Overall, the intensity of acute phase reactions was lower in the intervention group, indicating less damage associated with titanium and gafnium nitrides coated implants use.

intramedullary osteosynthesis, implants, acute phase reactants, super-hard metal nitrides