Detection of Biomarkers for Prosthetic Infection Type - (DEBIT)

Prosthetic joint infection (PJI) is a significant cause of failure in hip and knee arthroplasty and is often difficult to diagnose using current methods. This study aims to identify novel biomarkers for early and accurate diagnosis of PJI using nanopore sequencing technology (Oxford Nanopore Technologies). By analysing microbial profiles and host immune responses in samples from patients undergoing revision surgery, the study will compare infected and non-infected cases. Biomarkers will be investigated in periprosthetic tissue as well as less invasive sample types, including synovial fluid and blood, with the goal of improving early diagnosis and guiding future treatment strategies.

Inclusion Criteria: * Male or Female, aged 18 years or above. * Due to undergo prosthetic revision surgery for any reason identified by the clinical team. * Participant is willing and able to give informed consent for participation in the study. * Pre-operative blood samples and at least 5 substantial peri-prosthetic tissue samples of a suitable size to be distributed between labs as outlined were successfully collected (note that it may not be possible to collect synovial fluid in all cases). Exclusion Criteria: * The participant has previously undergone any kind of revision surgery for their hip implant. * The participant has received any antibiotic treatment within the previous two weeks (excluding antibiotics at induction). * Participant lacking capacity to give informed consent. * Any other clinical reason the participant should not be included in the study- at the discretion of the clinical team.