Charity funding helps make bone surgery safer

Posted by June Heath on 12 March 2025

RNOH is leading a ground-breaking project to improve the use of antibiotics in bone tumour surgery. These procedures often involve replacing bones with new pieces, known as endoprosthetics. This helps patients avoid amputation and regain function, usually very successfully. However, at around 10%, the infection rate for these major procedures is up to 20 times higher than in standard hip and knee replacements.

Infection is devastating for patients, the researchers say, requiring more time in hospital and the risk of additional surgery, impacting day-to-day life at school and work, and causing long-lasting complications.

To combat this, a team of experts is benefiting from RNOH Charity funding in their quest to find the best plans for these operations, including the right treatment, dose and timing. Part of the investigations include a process known as phage therapy, designed to fight antibiotic-resistant infections using bacteriophages, viruses that specifically target and destroy bacteria. It’s a concept that goes back to techniques originally deployed during the First World War and which could now have a huge impact on modern-day medicine.

RNOH Charity funding means researchers can test new methods for analysing bone samples to measure drug levels at surgical sites. This could pave the way for better, personalised use of antibiotics in bone tumour surgery and other conditions, improving safety and reducing infections.

An article on the use of phage therapy at RNOH was published in The Telegraph in late 2024. Science Correspondent Joe Pinkstone highlighted the potential to save the NHS millions of pounds over time and the crucial role played by RNOH staff in furthering its use.

The article focused on the successful treatment at RNOH of a patient with a severe bacterial infection contracted elsewhere, using phage therapy. This innovative approach not only improved the patient's quality of life but also demonstrated the cost-effective alternative to traditional antibiotics that the researchers are addressing.

Far-reaching impact

The team says managing infected hip replacements costs a hospital between at least £20,000 and £60,000 each time. Conservative estimates put deep surgical site infection at over £390,000 per case. Optimising procedures will therefore make clear savings across the NHS.

The research should help fight the overuse of antibiotics too, a major cause of drug resistance, by promoting smarter, more targeted use. The results may also contribute knowledge that shapes future protocols and global guidelines, ensuring operations are safer worldwide.

By creating a model for studying antibiotics in surgery, this project has the potential to improve care for patients everywhere and it is thanks to RNOH Charity supporters that the next step in this important journey can be taken.

Image: L to R: Antonia Scobie, Consultant in Infectious Diseases and Microbiology; Tariq Azamgarhi, Specialist Antimicrobial Pharmacist; Jonathan Miles, Consultant Orthopaedic Surgeon