Infection and biofilm antibiotic tolerance is one of the largest clinical challenges in orthopaedic surgery. The goal of this project is to understand how to improve the clinical outcomes in the treatment of implant infection. These publications demonstrate that irrigation, debridement, and antibiotics are unable to completely remove biofilm from arthroplasty implants. This serves as the foundation for current clinical studies demonstrating the role of bacterial persisters and toxin-antitoxin systems in biofilm antibiotic tolerance, and suggests new treatment strategies.
- Urish KL, DeMuth PW, Kwan BW, Craft DW, Ma D, Haider H, Tuan RS, Wood TK, Davis CM. (2016) Antibiotic tolerant Staphylococcus aureus biofilm persists on arthroplasty materials. Clinical Orthopaedic and Related Research. In Press. PubMed PMID: 26831479.
- Manrique J, Bedair H, Goyal N, Dietz M, Urish KL, Hansen VJ, Hamilton W, Parvizi J. (2015) A history of treated periprosthetic joint infection increases the risk of subsequent different site infection. Clinical Orthopaedic and Related Research.473 (7), 2300-2304. PubMed PMID: 25670654.
- Urish KL, Demuth P, Haider H, Craft DW, Davis, CM. (2015) Pulse lavage is inadequate at removal of biofilm from the surface of total knee arthroplasty components. Journal of Arthroplasty. 29(6), 1128-1132. PubMed PMID: 24439797.
- Urish KL. (2016) Biofilm is Persistant. AAOS Now 2016.
IMPLANT DESIGN & CORROSION
Arthroplasty design is a critical component of long-term outcomes and implants survival in joint replacement surgery. Taper corrosion, trunnion failure, and adverse local tissue reaction (ALTR) are rare but devastating problems that limit overall implant survival that are related to corrosion. There are a series of studies in progress being completed to improve the diagnosis and treatment of corrosion in arthroplasty surgery to increase overall implant survival.
- Urish KL, Hamlin BR, Plakseychuk AY, Levison TJ, Kurtz SM, DiGioia AM. (2017) Trunnion failure of the recalled LFIT cobalt chromium alloy femoral head. Journal of Arthroplasty. In Press.
- Liow MH, Urish KL, Preffer Fl, Nielson GP, Kwon YM. (2016). Metal ion levels are not correlated with histopathology of adverse local tissue reactions in taper corrosion of total hip arthroplasty. Journal of Arthroplasty. In Press. PubMed PMID: 26923497.
- Urish KL, Anderson PA, Mihalko, WM, AAOS Biomedical Engineering Committee.(2013). The challenge of corrosion in orthopaedic implants. AAOS Now, 7(4).