Novel approaches to prosthetic joint infection

Abstract

Prosthetic joint infection is a devastating complication affecting around 1% of joint replacements. Patients affected by this frequently require multiple surgeries to try to eradicate the infection in addition to prolonged courses of antibiotics. The diagnosis of infection in itself can be challenging. This work has explored novel approaches to diagnosing joint replacement infection using the Fc receptor CD64 found on neutrophils in peripheral blood as well as new diagnostic markers in synovial fluid using Alpha Defensin. The treatment of joint replacement infection is controversial and this thesis explores the results of patients treated with a less invasive approach known as Debridement Antibiotics and Implant Retention (DAIR). In addition prevention strategies have also been explored with a particular focus on the use of laminar flow operating theatres and an exploration of their effectiveness in the presence of operating theatre lights.