Prosthetic joint infection (PJI) is a significant cause of failure in hip and knee arthroplasty and is often difficult to diagnose using current methods. This study aims to identify novel biomarkers for early and accurate diagnosis of PJI using nanopore sequencing technology (Oxford Nanopore Technologies). By analysing microbial profiles and host immune responses in samples from patients undergoing revision surgery, the study will compare infected and non-infected cases. Biomarkers will be investigated in periprosthetic tissue as well as less invasive sample types, including synovial fluid and blood, with the goal of improving early diagnosis and guiding future treatment strategies.
Prosthetic joint infection (PJI) represents one of the most common reasons for failure among hip and knee arthroplasty, with an incidence of around 1-2%. Diagnosing infection can be challenging, as loosening of the implant cement (osteolysis), damage, and metal reactions can be impossible to differentiate without invasive procedures. Given the significant costs to the NHS for corrective revision surgery, the added suffering and risks to patients from surgery, and the risk of enhancing antimicrobial resistance through the use of broad-spectrum antibiotics, a predictive test for early diagnosis of infection is required. In this study, we will use nanopore sequencing platforms from Oxford Nanopore Technologies (ONT) to identify potential novel biomarkers for PJI in samples collected from patients undergoing revision surgery. This study will explore the microbes present, along with the host's immunological response, to identify potential novel biomarkers in infected samples compared to those revised for other reasons. The investigators will test for detection of these biomarkers in tissue surrounding the implant, as well as in less invasive sample types (synovial fluid and blood). These will provide novel biomarkers for diagnosis and early treatment of PJI for the future.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
BASIC_SCIENCE
Masking
NONE
Enrollment
40
Primary joint replacement
Queen Alexandra Hospital
Portsmouth, United Kingdom
RECRUITINGSouthampton General Hospital
Southampton, United Kingdom
NOT_YET_RECRUITINGBacterial abundance- comparison between patients
Bacterial abundance in infected biofilms compared to non-infected biofilms on hip arthroplasty prostheses.
Time frame: through study completion, an average of 1 year
Gene expression levels
Gene expression levels in patients with PJI compared to those undergoing revision surgery for other reasons (e.g. aseptic loosening (osteolysis), periprosthetic fracture, dislocation, etc.).
Time frame: through study completion, an average of 1 year
Bacterial abundance in blood and synovial samples
Secondary outcome measures are the bacterial abundance in blood and synovial samples taken from patients with infected prostheses compared to those with no infection.
Time frame: through study completion, an average of 1 year
Gene expression in blood and synovial samples
Secondary outcome measures are the bacterial gene expression in blood and synovial samples taken from patients with infected prostheses compared to those with no infection.
Time frame: through study completion, an average of 1 year
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