Imaging-based effectevaluation of atorvastatin on infectious fractures of endophytes in rats

Gao Yuhai; Pang Yongjie; Sun Wei; Zhang Qi; Wei Zhenglong; Liu Minna; Chen Keming

doi:10.3969/j.issn.1009-4237.2026.02.009

Abstract：Objective To evaluate the effects of atorvastatin(ATV)on implant-associated infection in a rat fracture model based on radiographic assessment.Methods Forty male SD rats weighing 200-220 g were randomly divided into 4 groups using a random number table:Model group,low-dose group(ATV-L),medium-dose group(ATV-M),and high-dose group(ATV-H),with 10 rats in each group.An open fracture with inplant infection mod-el by staphylococcus aureus was established in the right femur of rats.Oral administration commenced 3 d post-sur-gery.The ATV-L,ATV-M,and ATV-H groups received concentrations of 10.5,21.0,and 42.0 mg/kg,respective-ly,while the Model group received an equal volume of saline.Weighing was performed weekly,with radiographic ex-ams conducted biweekly to assess callus formation.Rats were euthanized at 8 weeks for tissue collection,general con-dition evaluation,and safety assessment.Micro-CT scans were conducted to analyze the fracture sites with 3D recon-struction.Femur sections were embedded,stained with hematoxy lin-eosin(HE)and safranin O-fast green,to exam-ine inflammatory changes and fracture healing.Results No statistically significant differences were observed in body weight or organ coefficients among groups(P＞0.05).Individual rat deaths occurred due to infection or anes-thesia,with the survival rates of 70%in the Model group,100%in the ATV-L group,90%in the ATV-M group,and 80%in the ATV-H group.Compared with the Model group,the ATV-L group revealed significantly higher callus scores at 4,6,and 8 weeks(all P＜0.05),while the ATV-M and ATV-H groups showed much higher callus scores at 6 and 8 weeks(all P＜0.05).The bone callus of the ATV-L group was 1.43±0.25,1.97±0.27,and 2.15±0.30 at 4,6 and 8 weeks,respectively,which were much higher than those of the ATV-M group(1.18±0.33,1.64±0.20,and 1.74±0.19)and ATV-H group(1.08±0.21,1.24±0.09,and 1.51±0.05)at corresponding time points(all P＜0.05);moreover,comparison between the ATV-H and ATV-M groups revealed much lower values of the former at 6 and 8 weeks(both P＜0.05).Micro-CT results indicated that the ATV-L group exhibited faster fracture healing compared to both the ATV-M and ATV-H groups.HE and safranin O-fast green staining of the femurs also demon-strated superior fracture healing in the ATV-L group compared to the other three groups.Conclusion Low dose of ATV(10.5 mg/kg)treatment significantly inhibits postoperative implant-associated infection and accelerates heal-ing of infected fractures.