Premedication of Patients Undergoing Dental Procedures Causing Bacteremia after Total Joint Arthroplasty

Aminoshariae, Anita; Kulild, James C.

doi:10.1016/j.joen.2010.03.027

Cited by 6 publications

(2 citation statements)

References 39 publications

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“…In 2014, 95,515 total hip and knee replacements were performed in Australia, and this has increased by 58.6% for hip replacements and 88.3% for knee replacements since 2003 [26] . Infection rates are very low, but an infected prosthetic joint will result in significant morbidity for the patient often requiring revision surgery [1] , [27] , [28] . Respondents to this survey reported very low infection rates among their patients but generally considered the outcome of a PJI so dire; all attempts should be made to avoid it.…”

Section: Discussionmentioning

confidence: 99%

Antibiotic prophylaxis for dental treatment after prosthetic joint replacement: exploring the orthopaedic surgeon's opinion

McNally

Visvanathan

Liberali³

et al. 2016

Arthroplasty Today

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BackgroundAntibiotic prophylaxis before dental treatment is routinely recommended by orthopaedic surgeons to prevent prosthetic joint infection (PJI). This recommendation is at odds with current guidelines.MethodsA postal survey of 9 checkbox or short-answer questions was completed by 633 orthopaedic surgeons.ResultsThe majority of respondents (n = 186 of 260, 72%) believe that antibiotic prophylaxis is required indefinitely for dental treatment. A small number (n = 43, 15%) seek a dentist's opinion before elective joint replacement. The surgeons reported low numbers of PJIs, although 24% (n = 68 of 280) believed that they were associated with dental treatment.ConclusionsAustralian orthopaedic surgeons continue to recommend antibiotic prophylaxis for dental treatment. The recording of PJI in relation to dental procedures into clinical registries would enable the development of consistent guidelines between professional groups responsible for the care of this patient group.

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Section: Discussionmentioning

confidence: 99%

Antibiotic prophylaxis for dental treatment after prosthetic joint replacement: exploring the orthopaedic surgeon's opinion

McNally

Visvanathan

Liberali³

et al. 2016

Arthroplasty Today

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“…Controversy exists in the literature regarding antibi- otic prophylaxis. 18 At least 1 professional organization representing dental practitioners-American Academy of Oral Medicine-has repudiated the 2009 AAOS guideline and instead recommends following the 2003 consensus ADA/AAOS guideline. 19 Lockhart et al 16 studied bacteremia in the context of toothbrushing and dental extraction and reported that simple toothbrushing provoked bacteremia in 32% of patients, which suggests that a typical patient is exposed to more than 200 episodes of bacteremia per year.…”

Section: Discussionmentioning

confidence: 99%

Hematogenous Infection of Total Hip Arthroplasty With Actinomyces Following a Noninvasive Dental Procedure

Brown¹,

Drinkwater²

2012

Orthopedics

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This article describes a case of an infected total hip arthroplasty following a dental procedure. A 59-year-old man underwent total hip arthroplasty for osteoarthritis and had a routine recovery. Approximately 9 months postoperatively, he underwent a dental cleaning without antibiotic prophylaxis. One month later, he reported gradually worsening right hip pain and a purulent discharge. After several unsuccessful interventions, the patient was referred to the authors’ facility. The patient’s history, draining sinus tract, and radiographic changes were considered diagnostic of a late chronic infection, and the patient underwent 2-stage revision. Intraoperatively, the sinus tract extended directly to the acetabular component. Actinomyces spp were isolated from 3 of 7 intraoperative anaerobic cultures, and the patient received penicillin G for 8 weeks. Two weeks after discontinuing antibiotics, with no clinical manifestation of recurrent infection and a negative hip aspiration, a new hip prosthesis was implanted. The patient was prescribed penicillin for 12 months postoperatively. Harris Hip Score was 100 at 52-month follow-up. The American Dental Association and the American Academy of Orthopaedic Surgeons issued consensus guidelines for chemoprophylaxis in orthopedic patients undergoing dental procedures in 1997 and 2003. Although the American Academy of Orthopaedic Surgeons issued a revised guideline in 2009 recommending more robust antibiotic prophylaxis, significant controversy exists because at least one professional organization representing dentists has repudiated the 2009 American Academy of Orthopaedic Surgeons guideline. The authors describe the implications from their experience and similar cases in the literature with regard to such guidelines.

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Clinical and regulatory considerations of implantable medical devices

Makovey

Gad

Scherer³

et al. 2015

Implantable Biomedical Microsystems

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Premedication of Patients Undergoing Dental Procedures Causing Bacteremia after Total Joint Arthroplasty

Cited by 6 publications

References 39 publications

Antibiotic prophylaxis for dental treatment after prosthetic joint replacement: exploring the orthopaedic surgeon's opinion

Antibiotic prophylaxis for dental treatment after prosthetic joint replacement: exploring the orthopaedic surgeon's opinion

Hematogenous Infection of Total Hip Arthroplasty With Actinomyces Following a Noninvasive Dental Procedure

Clinical and regulatory considerations of implantable medical devices

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