Work Package 03: Differentiation of Septic and Aseptic Conditions in Connection with Loosening of Prostheses

  • Work Package Lead
    Jan Lorenzen
    Danish Technological Institute
  • Partners Involved
    University of Magdeburg
    University of Tartu
  • Description
    Adverse immune reactions are at the centre of the research and development work of the project. However, low grade infections in artificial joints are very difficult to diagnose and a mixture of infected and not infected patients would make the interpretation of immunological data inaccurate. Therefore, special attention is paid to the differentiation of septic and aseptic loosening of prostheses. Hence, WP03 will develop an improved common diagnostic standard operating procedure (SOP) for the differentiation of aseptic loosening and infection and will apply this SOP on at least 120 patients receiving revision total hip or knee arthroplasty (THA/TKA) (patient pool III). This will allow the needed clear distinction between aseptic inflammation caused by e.g. implant material and septic inflammation processes caused by pathogens. Additionally, the case of both states in patients is possible.

    The work package is divided into three tasks:
    The development of improved diagnostic SOP allowing the reliable distinction of septic and aseptic conditions in connection with loosening of prostheses.
    The analysis of clinical specimens for microbiological diagnosis of 120 patients receiving revision surgery. This includes routine culture of perioperatively obtained clinical specimens and additionally molecular biological analysis of similar clinical specimens employing PCR-technology and next generation sequencing. On the basis of these data patients are categorized as either being aseptic or septic cases.

    The interpretation of microbiological results together with clinical data (e.g. osteolysis, x-ray data, Work Package 01), cytokine profiles (Work Package 04) and transcriptomic data (Work Package 05). Datamining will be performed on the basis of the jointly collected clinical data obtained by analysing clinical specimens and by clinical investigation of the patients in order to identify possible biomarkers with clinical relevance, e.g. differentiating septic and aseptic cases etc.
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