Identification of biomarkers for early diagnosis of prosthetic joint infection

Around 1–2% of hip and knee replacements fail because of an infection that is nearly impossible to distinguish from routine implant loosening without invasive surgery. This matters because surgeons currently cannot tell, from standard tests or scans, whether a painful joint is infected or simply loose. The only reliable way to find out is to open the joint and take tissue samples—a major operation that carries its own risks. Patients suffer additional surgery and prolonged courses of broad-spectrum antibiotics, which fuel antimicrobial resistance. The NHS also bears the high cost of these revision procedures. The research team will use nanopore sequencing to read the genetic material in fluid and tissue samples from patients already undergoing revision surgery. By comparing samples from infected joints with those revised for non-infectious reasons, they aim to identify microbial DNA and host immune signals that reliably flag infection. If successful, this work could produce a simple diagnostic test that spares patients unnecessary surgery, reduces antibiotic overuse, and saves the NHS significant expense. The biomarkers identified here would allow clinicians to treat infection early, before it destroys the implant and surrounding bone.