Thorsten M. Seyler, MD, PhD
Assistant Professor in Orthopaedic Surgery
The Seyler Lab focuses on periprosthetic joint infections, a serious complication after hip and knee arthroplasty. The incidence of periprosthetic joint infection (PJI) is reported to range from 2.0-2.4% of cases and is on the rise in the United States, as are the annual cases and cost of infected total joint arthroplasty revisions. An analysis of the National Inpatient Sample database found that PJI was the most common reason for revision total knee arthroplasty and the third most common diagnosis for revision total hip arthroplasty procedures.
With the increased use of implantable devices such as total joint arthroplasties, the number of biofilm-associated infections has emerged as a significant financial burden and clinical problem because biofilms are often resistant to traditional antimicrobial therapy and difficult to eradicate. Biofilm cells show as much as a 1,000-fold more resistance to traditional antimicrobial therapy than their planktonic cell counterparts, and biofilm-based microbial infections make up up to 80% of all infections in patients, leading the CDC to declare biofilms to be one of the most important medical hurdles of the century.
Periprosthetic joint infections represent a major challenge to the total joint surgeon, and this epidemiologic health problem consumes significant resources for prevention, diagnosis, and management. The focus of the Seyler Lab is biofilm research associated with PJI. The lab's multidisciplinary biofilm research initiative aims to advance the understanding of the formation of biofilms and the ability to diagnose biofilm-associated infections, and to develop/use novel treatment approaches to prevent and treat biofilm-associated infections.
- Develop an imaging modality that is capable of diagnosing biofilm-related infections and can be used to monitor treatment outcomes longitudinally
- Develop a treatment approach to biofilm-associated implant infections using metabolites from marine sponges that have been found to have anti-biofilm properties
- Establish a reliable animal model of staphylococcus aureus biofilm that can be used by multiple collaborators to study novel imaging modalities, characterize the ability of antimicrobial agents, and evaluate prophylactic effect of novel implant coatings
- Develop an antibiotic-releasing spacer for two-stage revision procedures that does not interact with antibiotics and has stability and strength independent of what type of antibiotic is delivered
Selected Publications and Grants
Additional grants outside of Duke:
- Seyler, T. M.; Poehling, G. G.; Whitlock, P. W.; Smith, T. L.; and Van Dyke, M. W. A Tissue-Engineered Approach to Tendon and Ligament Reconstruction Using Human Achilles Tendon Allograft-Derived Scaffolds. Sponsor: Musculoskeletal Transplant Foundation. Non-Transplantable Tissue Program Grant. 2007.
- Seyler, T. M.,; Poehling, G. G.; Van Dyke, M. W.; Whitlock, P. W.; and Smith, T. L. Tissue Engineering of Tendons and Ligaments Using Adipose-Derived Stem Cells and a Novel Naturally-Derived Scaffold. Sponsor: Orthopaedic Research and Education Foundation. $19,230. 2008.
- Seyler, T. M.; Poehling, G. G.; Whitlock, P. W.; Smith, T. L.; and Van Dyke, M. W. A Tissue-Engineered Approach to Tendon and Ligament Reconstruction Using Human Achilles Tendon Allograft-Derived Scaffolds. Sponsor: Community Blood Center, Community Tissue Services, Dayton, Ohio. Non-Transplantable Tissue Program Grant. 2008.
- Seyler, T. M.; Whitlock, P. W.; Smith, T. L.; Van Dyke, M. W.; and Poehling, G. G. ACL Reconstruction in a Rabbit Model using a Novel, Biocompatible Human Achilles Allograft Tissue-Derived Ligament Scaffold. Sponsor: Arthroscopy Association of North America. $24,980. 2008-2010.
- Lang, J. E.; Seyler, T. M.; and Scott, R. D. The Effect of Patellar Thickness on Knee Flexion and Patellar Tracking: A Comparison of the Sigma CR and Sigma CR150 High-Flexion Knee. Sponsor: DePuy Orthopaedics, Inc. $10,000. 2009-2010.
- Tuohy, C. J.; Mannava, S.; Seyler, T. M.; Smith, T. L.; Whitlock, P. W.; and Van Dyke, M. W. Optimization of Bioreactor Preconditioning Protocols for the Maturation of Seeded, Naturally Derived Scaffold. Sponsor: Wake Forest University Intramural Research Grant. $20,000. 2010-2012.
- Hutchinson I. D. & Seyler T. M. Continuous Monitoring of Compartmental Pressures Using Somatosensory Evoked Potentials for Compartment Syndrome at the Bedside, Ward, and Using Live Telemedicine Feed to Healthcare Professionals. SPARK Commercialization Pathway Award 2014, Wake Forest University/Wake Innovations Grant. $25,000. 2014-2015.
- Thorsten M. Seyler, MD, PhD, Principal Investigator (Dept. of Orthopaedic Surgery)
- Ken Gall, PhD, Collaborator (Dept. of Mechanical Engineering and Materials Science)
- Vance G. Fowler, MD, MHS, Collaborator (Dept. of Internal Medicine)
- Matthew J. Hilton, PhD, Collaborator (Dept. of Orthopaedic Surgery)
- Courtney M. Karner, PhD, Collaborator (Dept. of Orthopaedic Surgery)
- Joseph G. Mammarappallil, MD, PhD Collaborator (Dept. of Radiology)
- Terese Camp, Lab Manager (Dept. of Orthopaedic Surgery)
Dr. Seyler is always looking to supervise enthusiastic graduate students, post-docs, and lab technicians. Individuals with interest in any of his ongoing projects, or with a desire to build off of his expertise to explore related areas of research, should contact him.
4709 Creekstone Drive, Durham, NC 27703
DUMC Box 2887, Durham, NC 27710
 Kurtz SM, Lau E, Watson H, Schmier JK, Parvizi J. Economic burden of periprosthetic joint infection in the United States. J Arthroplasty. 2012 Sep;27(8 Suppl):61-5.e1.
 Kamath AF, Ong KL, Lau E, Chan V, Vail TP, Rubash HE, Berry DJ, Bozic KJ. Quantifying the Burden of Revision Total Joint Arthroplasty for Periprosthetic Infection. J Arthroplasty. 2015 Sep;30(9):1492-7.
 Percival SL, Suleman L, Vuotto C, Donelli G. Healthcare-associated infections, medical devices and biofilms: risk, tolerance and control. J Med Microbiol. 2015 Apr;64(Pt 4):323-34.
 Issues in healthcare settings: CDC's seven healthcare safety challenges. Atlanta, GA: 2001.