New study investigates how probiotics can improve outcomes in knee replacement surgeries

Dr. Matthew Teeter, PhD, and team are investigating the connection between the gut biome and positive knee replacement surgical outcomes.

By Lawson Research Communications

Researchers at Lawson Health Research Institute are examining whether the use of a daily probiotic can improve outcomes in patients who undergo total knee replacement surgery.

There are more than 70,000 knee replacement surgeries in Canada each year, and up to 10 per cent of patients experience complications following the procedure.

“One in five patients is dissatisfied after surgery due to pain and discomfort, and some patients need a repeat surgery because there is complication, infection or loosening of the joint,” said Dr. Matthew Teeter, PhD, Lawson Scientist at London Health Sciences Centre (LHSC). He is also an associate professor in the departments of Medical Biophysics, Surgery and Medical Imaging at Schulich School of Medicine & Dentistry and a Robarts Research Institute scientist.

Teeter and the research team are focused on improving patient outcomes. Recognizing that knee replacement patients who are considered healthy tend to have better outcomes, they are interested in how they can better support patients’ overall health as one way to optimize their results.

“The knee replacement patients I see in clinic are very diverse - from young, healthy, active patients to medically complex to socioeconomically disadvantaged,” said Dr. Brent Lanting, Lawson Scientist and Orthopaedic Surgeon at LHSC. “We know those with poor health do not do as well as those with good health, good diet, and good supports. This study is profound in that it investigates a core aspect of our health – the gut microbiome.”

The research team will recruit 30 participants who are scheduled for a knee replacement surgery. Half of the participants will receive a daily probiotic for six weeks ahead of the surgery, and the other half will act as a control group.

“Our microbiome is a large part of why we are healthy. A healthy person has a microbiome that produces vitamins and other things which cross over to our system and helps to promote healing,” said Dr. Jeremy Burton, Lawson Scientist and Research Chair of Human Microbiome and Probiotics at St. Joseph’s Health Care London. Burton is also an assistant professor in Urology, in the Department of Surgery and cross-appointed to the Department of Microbiology & Immunology at Schulich Medicine. “We are hoping it will improve more deep healing and prevention of the rejection of the joint by improving the microbiota by giving probiotics.”

The team will assess outcomes using CT imaging, looking at the bone and implant and how it is fixed into place. They will also use PET/MRI to look at the cellular activity around the joint and inflammation.

“This should give us a sharp focus of what is going on with the joint and help us determine if there was a positive effect by using probiotics,” said Teeter.

If the pilot study proves to be promising, the team will then work towards a larger clinical trial, combining probiotics into pre-surgical care.

“Ultimately, we want better patient outcomes with a simple treatment,” added Burton. “If we can help improve outcomes with the use of a daily probiotic, that is a great win.”

The research team received a New Frontiers in Research Fund (NFRF) of $250,000 over three years to conduct this study.