Total joint arthroplasty is widely regarded as one of the most successful procedures in modern medicine, restoring limb function and eradicating pain. Thankfully success rates are high and failure rates due to infection are low – in the order of 1-2% in most centres. However with the numbers of total joint arthroplasties undertaken each year even 1% infection is a significant burden. It is vitally important for successful patient outcomes that infections are diagnosed correctly and patients managed optimally either by one or two-stage revisions, with appropriate choices of antibiotics and route of delivery (IV, oral or via loaded bone cement).  Occasionally girdlestones arthrodesis or even long-term antibiotic suppression may be required.

Here at the UK Orthopaedic Microbiology Service we have a dedicated senior laboratory scientist with 21 years experience in the laboratory diagnosis of prosthetic joint infections and also a dedicated medically qualified microbiology consultant who is a nationally respected Orthopaedic Microbiologist.  Our aim is to interpret the results, help you to plan your revision surgery and advise on the optimum choice of antibiotics, all of which is required to achieve a successful patient outcome.

Our specialist orthopaedic service can offer:

• Timely transport of specimens from your operating theatre to our specialist laboratory
• Diagnostic Aspirates or Bone Biopsies (depending on surgical preference) pre-revision surgery and interpretation of the result to optimise the antibiotic management of the 1 or 2 stage revision
• First and second stage tissue processing (Minimum of 5 samples)
• Optimum processing of the samples by trained scientists under laminar flow conditions (a facility not available in many laboratories) in accordance with nationally agreed Standard Operating Procedures
• Accurate and timely organism(s) isolation and identification
• Accurate Antibiotic Sensitivity Testing based on the organism(s) isolated and route of delivery of the appropriate antibiotics (cement or systemic)
• Clinical Interpretation of results
• Reporting of results back to requesting surgeon
• If required clinical advice/discussion with requesting surgeon on options for managing the patient (whether one-stage, two-stage and antibiotic choices for systemic and/or cement)

I’ve known Dr Rob Townsend and Mr Steve Davies for quite a few years now, as well as participating in research programmes on joint infections together we also co-organise a highly successful annual orthopaedic/microbiology meeting bringing together experts in the fields of microbiology and orthopaedic surgery. On the clinical side we conduct weekly ward rounds and MDT’s and I have to say that I rely upon their accurate results, their professional service, clinical acumen and advice for the optimum management of my patients, many of whom are complicated referrals from other centres.

Professor Ian Stockley, Consultant Orthopaedic Surgeon, immediate past President of the British Hip Society and specialist in Revision Arthroplasty, Sheffield, recently listed as one of the top 10 hip surgeons in the UK (Daily Mail 2010).