Researchers from the ROH have published the first clinical evidence supporting the use of real-time fluorescence imaging during revision knee arthroplasty for periprosthetic joint infection.
Published in BMJ Open, the independently conducted feasibility study by leading surgeons at the ROH, "Can
a fluorescent imaging device (MolecuLight) function as an adjunct to surgical debridement during revision
knee arthroplasty for periprosthetic infection in a tertiary centre: a feasibility study," reports the first clinical
evidence supporting the use of the MolecuLightDX imaging device during revision knee arthroplasty for
periprosthetic joint infection.
Periprosthetic joint infection is one of the most serious complications following joint replacement surgery.
Complete removal of infected tissue through radical surgical debridement is critical to reducing the risk of
persistent or recurrent infection yet identifying all areas of bacterial contamination remains challenging.
In this prospective 10 patient pilot study conducted at the ROH, surgeons used MolecuLight fluorescence
imaging following standard surgical debridement to assess the operative field for residual bacterial burden.
Areas exhibiting bacterial fluorescence that had not been identified during the initial debridement were
subsequently biopsied, with microbiological analysis confirming the presence of the same bacterial species
responsible for the periprosthetic joint infection.
“This feasibility study is suggestive that the MolecuLight device may assist surgeons in improving their radical
debridement at the time of revision surgery of the knee for prosthetic joint infection, which is considered the
key step to minimising the morbidity of recurrent infection,” said Professor Jonathan Stevenson, senior author
and Consultant Orthopaedic Surgeon at the Royal Orthopaedic Hospital, Birmingham. “This is the first step in
understanding how MolecuLight can be used to assist in these complicated surgeries. Further, larger studies
are required to confirm these exciting and novel findings.”
Mr James Archer, Speciality Registrar in Trauma and Orthopaedics at the ROH and the first author, echoes
“This feasibility study provides the first work to demonstrate that MolecuLight may be able to aid surgeons
intra-operatively during revision surgery for periprosthetic joint infection of the knee. We look forward to
performing larger studies to examine this in more detail.”
"This publication represents an important milestone for fluorescence imaging beyond chronic wound care,"
said Anil Amlani, Chief Executive Officer of MolecuLight. "We commend the outstanding work of Professor
Stevenson, Mr. Archer and the team at the ROH. Their research provides the first published evidence
supporting the potential use of real time fluorescence imaging during orthopaedic surgery and establishes an
important foundation for future clinical investigation."
This publication opens up new avenues for MolecuLight’s growing role in perioperative surgical applications
worldwide. By providing surgeons with immediate visual information about residual bacterial burden that
may otherwise remain undetected, this technology has the potential to support more informed intraoperative
decision making. Further research to relate these findings to positive surgical outcomes could demonstrate a
decrease in additional resection surgeries and fewer infection complications.
