Associate 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) ranges from 2.0-2.4 percent of cases. The annual cases and cost of infected total joint arthroplasty revisions are on the rise in the United States.[1] 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.[2]
With the increased use of implantable devices such as total joint arthroplasties, biofilm-associated infections have emerged as a significant financial burden and clinical problem because biofilms are often resistant to traditional antimicrobial therapy and difficult to eradicate.[3] Biofilm cells show as much as 1,000-fold more resistance to traditional antimicrobial therapy than their planktonic cell counterparts, and biofilm-based microbial infections make up to 80 percent of all infections in patients, leading the CDC to declare biofilms to be one of the most important medical hurdles of the century.[4]
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.
Current Projects
- Develop an imaging modality 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 with anti-biofilm properties.
- Establish a reliable animal model of staphylococcus aureus biofilm that multiple collaborators can use to study novel imaging modalities, characterize the ability of antimicrobial agents, and evaluate the prophylactic effect of novel implant coatings.
- Develop an antibiotic-releasing spacer for two-stage revision procedures that do not interact with antibiotics and have stability and strength independent of the type of antibiotic delivered.
Selected Publications and Grants
Publications
-
Duensing, Ian M., Billy I. Kim, Lefko T. Charalambous, Ayden Case, Peter A. Surace, Thorsten M. Seyler, and Samuel S. Wellman. “Clinical Outcomes After Stage-One Antibiotic Coated Molded Hip Spacer.” J Arthroplasty 37, no. 7S (July 2022): S664–68. https://doi.org/10.1016/j.arth.2022.02.116.
More info -
Belay, Elshaday S., Niall H. Cochrane, Albert T. Anastasio, Mark Wu, Michael P. Bolognesi, and Thorsten M. Seyler. “Risk Factors for Delayed Discharge and Adverse Outcomes Following Outpatient Billed Total Knee Arthroplasty.” J Arthroplasty 37, no. 6 (June 2022): 1029–33. https://doi.org/10.1016/j.arth.2022.02.045.
More info -
Charalambous, Lefko T., Billy I. Kim, Andrew M. Schwartz, Ayden Case, Jessica L. Seidelman, Edward F. Hendershot, Michael P. Bolognesi, Thorsten M. Seyler, and William A. Jiranek. “Prosthetic Knee Infection With Coagulase-Negative Staphylococcus: A Harbinger of Poor Outcomes.” J Arthroplasty 37, no. 6S (June 2022): S313–20. https://doi.org/10.1016/j.arth.2022.02.050.
More info -
Mathew, Kevin K., Kevin B. Marchand, John M. Tarazi, Zhongming Chen, Jeffrey A. O’Donnell, Thorsten M. Seyler, and Michael A. Mont. “Heterotopic Ossification Prophylaxis Following Operative Fixation of Acetabular Fractures: A Systematic Review.” Surg Technol Int 40 (May 19, 2022): 369–85. https://doi.org/10.52198/22.STI.40.OS1543.
More info -
Wu, Mark, Niall H. Cochrane, Billy Kim, Elshaday S. Belay, Jeffrey O’Donnell, Sean P. Ryan, William A. Jiranek, and Thorsten M. Seyler. “Patterns and Predictors of Weight Change Before and After Total Hip Arthroplasty in Class 2 and 3 Obese Patients.” J Arthroplasty 37, no. 5 (May 2022): 880–87. https://doi.org/10.1016/j.arth.2022.01.009.
More info -
Kim, Billy I., Niall H. Cochrane, Jeffrey A. O’Donnell, Mark Wu, Samuel S. Wellman, Sean Ryan, and Thorsten M. Seyler. “Preoperative Weight Loss and Postoperative Weight Gain Independently Increase Risk for Revision After Primary Total Knee Arthroplasty.” J Arthroplasty 37, no. 4 (April 2022): 674–82. https://doi.org/10.1016/j.arth.2021.12.003.
More info -
Charalambous, Lefko T., Zoe Hinton, Billy I. Kim, Ayden Case, Meredith Brown, William Jiranek, Jessica Seidelman, Michael P. Bolognesi, and Thorsten M. Seyler. “An analysis of 90-day emergency department visits after peripherally inserted central catheter (PICC) placement for prosthetic joint infection.” Infect Control Hosp Epidemiol, March 7, 2022, 1–6. https://doi.org/10.1017/ice.2022.22.
More info -
O’Donnell, Jeffrey A., Mark Wu, Niall H. Cochrane, Elshaday Belay, Matthew F. Myntti, Garth A. James, Sean P. Ryan, and Thorsten M. Seyler. “Efficacy of Common Antiseptic Solutions Against Clinically Relevant Planktonic Microorganisms.” Orthopedics 45, no. 2 (March 2022): 122–27. https://doi.org/10.3928/01477447-20211227-05.
More info -
Wu, Mark, Jeffrey O’Donnell, Niall Cochrane, Sean Ryan, Elshaday Belay, Matthew Myntti, and Thorsten Seyler. “Effect of commonly used lavage solutions on the polymerization of bone cement.” Orthop Traumatol Surg Res, February 11, 2022, 103243. https://doi.org/10.1016/j.otsr.2022.103243.
More info -
Wu, Mark, Ayden Case, Billy I. Kim, Niall H. Cochrane, Gabriela A. Nagy, Michael P. Bolognesi, and Thorsten M. Seyler. “Racial and Ethnic Disparities in the Imaging Workup and Treatment of Knee and Hip Osteoarthritis.” J Arthroplasty, February 11, 2022. https://doi.org/10.1016/j.arth.2022.02.019.
More info
Grants
- A Prospective Multicenter Longitudinal Cohort Study of the Mymobility Platform (Investigator), awarded by Zimmer Biomet Company, administered by Orthopaedics, 2019-2023 More info
- G7® Acetabular System (Principal Investigator), awarded by Zimmer Biomet Company, administered by Orthopaedics, 2021-2023 More info
- Surgical Risk Prediction, Performance, and Scheduling Suite (Principal Investigator), awarded by Piedmont Orthopedic Foundation, administered by Orthopaedics, 2021-2022 More info
- Perioperative Antibiotic Prophylaxis in Patients Undergoing Elective TJA (Principal Investigator), awarded by Orthopaedic Research and Education Foundation, administered by Orthopaedics, 2019-2022 More info
- STRIDES-1 (Principal Investigator), awarded by Samumed, LLC, administered by Orthopaedics, 2020-2021 More info
- Perioperative Antibiotic Prophylaxis in Patients Undergoing Elective Total Knee Arthroplasty: A prospective, randomized, open-label, controlled mult-center trial (Principal Investigator), awarded by American Association of Hip and Knee Surgeons, administered by Orthopaedics, 2017-2021 More info
- Retrospective / Prospective Multicenter Study of Commercially Available Zimmer Biomet Knee Implants (Principal Investigator), awarded by Zimmer Biomet Company, administered by Orthopaedics, 2019-2021 More info
- Saline Controlled Study of nSTRIDE APS for Knee Osteoarthritis (Principal Investigator), awarded by Biomet Biologics, LLC, administered by Orthopaedics, 2017-2021 More info
- Post Market, Randomized, Open-Label, Multicenter, Study to Evaluate the Effectiveness of Closed Incision Negative Pressure Therapy Vs Standard of Care Dressings in Reducing Surgical Site Complications in Subjects with Revision of Failed Total Knee (Principal Investigator), awarded by KCI USA Inc, administered by Orthopaedics, 2018-2020 More info
- Fresh Tissue Lab Agreement (Principal Investigator), awarded by Total Joint Orthopaedics, administered by Orthopaedics, 2018-2018 More info
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.
People
- 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)
Jobs
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.
Contact
4709 Creekstone Drive, Durham, NC 27703
DUMC Box 2887, Durham, NC 27710
919-684-5441
thorsten.seyler@dm.duke.edu
[1] 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.
[2] 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.
[3] 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.
[4] Issues in healthcare settings: CDC's seven healthcare safety challenges. Atlanta, GA: 2001.