- Dr B.G.C.W. Pijls, orthopaedics
- Prof. dr. R.G.H.H. Nelissen, orthopaedics
- Ing. I.M.J.G. Sanders, medical microbiology
- Prof. dr. E.J. Kuijper, medical microbiology
ZonMw Off road 451001003
Surgical revision for infected total joint replacement is one of the most invasive procedures, since often the implant has to be removed, thus causing a devastating effect for the patient's functionality and quality of life. Moreover, the mortality in patients revised for infection is 5 times higher than in patients revised for other reasons. Presently, the implant is considered part of the problem, which has to be removed if the bacterial biofilm at the implant cannot be cured. Remaining scar tissue and necrotic bone (due to multiple surgical procedures) further prevent adequate antibiotic levels to reach the remaining biofilm and may render it impossible to cure the infection at all, leaving the patient crippled without the implant and receiving life long antibiotic suppression therapy.
This research proposes a completely new way of approaching PJI. The implant should not be considered part of the problem. No, the implant is part of the solution, since it is needed to deliver the heat that kills bacteria directly within the biofilm in a non invasive way. No surgical approach with subsequent tissue damage and scar tissue is required. I intend to do this with a new ,completely non-invasive method: heating the metal implant in situ, through the skin, with “Pulsed Electro Magnetic Fields” (PEMF), also known as induction heating, directly at the metal-bacterial biofilm interface.
The ultimate destination of this off-road project is to reduce infection of metal implants is to a minor inconvenience for the patient: implant infection cured with treatment of induction heating in a matter of minutes followed by short term antibiotic treatment compared to the contemporary method of multiple surgical procedures, implant removal and long term (sometimes life long) antibiotic suppression treatment.