Phosphomycin-functionalised titanium – a novel strategy for minimising orthopaedic implant infections

Summary

Hip and knee joint disease can often require surgical replacement with a prosthesis. For the most part these total joint replacements (TJR's) have a high degree of success and will remain with the patient for the rest of their lives. Unfortunately, however, some TJR's get infected, often with the "superbug", MRSA. This has a huge impact on the patient who will have to undergo another surgical procedure to replace the infected prosthesis. There is a clear incentive therefore to find ways of minimising the risk of TJR infection. One way to do this could include coating the prosthesis with a suitable agent that is known to kill MRSA. We have chosen a clinically approved agent, phosphomycin, which was discovered in 1969. It is classified as a critically important medication and is part of the World Health Organisation's list of essential medicines. Phosphomycin is predicted to bind to titanium, a widely used metal for TJR's. Phosphomycin belongs to a group of agents that have a natural affinity for titanium. With the support of University Hospitals Bristol and Weston we will assess the potential of our phosphomycin-coated titanium to kill those bacteria typically implicated in TJR infections.