Development of a Three-Dimensional Bioartificial Shoulder Joint Implant Mimetic of Periprosthetic Joint Infection.

Abstract

Postsurgical infections of the shoulder joint involving <i>Cutibacterium acnes</i> are difficult to diagnose and manage. Despite the devastating clinical complications and costly health care burden of joint infections, the scarcity of joint infection models was identified as an unmet need by the 2019 International Consensus on Orthopedic Infections. In this study, we have developed a novel 3D shoulder joint implant mimetic (S-JIM) that includes a surgical metal surface and supports a co-culture of <i>C. acnes</i> and patient-derived shoulder capsule fibroblasts. Our findings indicate the S-JIM can generate a near anaerobic interior environment that allows for <i>C. acnes</i> proliferation and elicits fibroblast cell lysis responses that are consistent with clinical reports of tissue necrosis. Using the S-JIM, we have provided proof-of-concept for the use of mass spectrometry in real-time detection of <i>C. acnes</i> joint infections during surgery. The S-JIM is the first <i>in vitro</i> cell culture-based biomimetic of periprosthetic joint infection (PJI) that provides a preclinical method for the rapid and reliable testing of novel anti-PJI interventions. Impact statement We have developed the first 3D laboratory biomimetic of the postsurgical human shoulder joint to study periprosthetic joint infections.