BONEZONE discusses emerging technologies that address orthopedic surgical infections and includes insight from Mathias P. Bostrom, MD, chief of the Adult Reconstruction and Joint Replacement Service at HSS, about a simple blood test can be used to detect periprosthetic joint infections.

Dr. Bostrom explained, “Hip, knee and shoulder are great operations. No question about it. The downside, unfortunately, is that a very small percentage can get infected. The problem is that we can’t just wash out the joint and give you a ton of antibiotics because we still have all this retained hardware in there. We can’t take that out. So one of the challenges we have is not only treatment but also diagnosis. We never really know what the organism is that’s caused [the infection]. The only way to find out is to put a needle in the hip or the knee and pull out the fluid.”

Alongside a large team, Dr. Bostrom has developed a faster, less intrusive method for identifying infections using cell-free DNA.

He explained, “Cell-free DNA is the genetic material that’s floating around in your bloodstream. It will give you a signal that an organism has been in blood and that there is an infection taking place. I started looking at cell-free DNA in pregnancy to look for abnormalities. But this is now applied to infections.”

Dr. Bostrom and colleagues worked with the medical technology firm Karius to discover that the method could detect infections in joint replacement patients via a simple blood test rather than pulling fluid out of knees, hips and shoulders. According to Dr. Bostrom, this method of infection detection allows experts to recognize specific sensitivities related to bacteria and identify multiple organisms, an asset not available through conventional methods.

He added, “Treating the infection means usually taking everything out, cleaning it out, applying an IV and antibiotics, and then finally time to put a new knee or hip in the patient. We never really know when it is the right time to take these steps. But this technology could be very useful in that setting. If the cell-free DNA is negative, it’s probably a good time to replant it. On the other hand, if the cell-free DNA sample is still positive for an infection, we gotta be aggressive and do something different, not put a brand new hip or knee in there.”

Read the full article at Bonezonepub.com.