Prevention of late haematogenous infection in major prostetic joints

Low incidence of haematogenous seeding to total hip and knee prostheses in patients with remote infections

“…10 In the literature, the time delay between the onset of any remote infection and the first symptoms of prosthesis seeding has seldom been reported. 17 Our report stands in contrast to others. Tsukayama et al found a delay of 2e7 days, 15 and Murdoch et al, 0e65 days.…”

“…A pulmonary predominance 14,22 alternates with the urinary tract 19,26 or skin. 9,13,17,20,27 Skin infections often involve the distal portion of the lower extremities, 17,20,23 with spread of the infection to a knee or hip prosthesis by the lymphatic route 9,13e 15,17,23 rather than by haematogenous seeding. Indeed, only about 2% of all cellulitis is bacteraemic.…”

“…16 Most reports of haematogenous infections are single case reports 17e21 from the 1970s to 1980s. 7,8,13,17,22,23 At times it is unknown if the bacteraemia preceded the joint infection 12,24 or is in fact secondary to it. 9,14,22,25,26 Moreover, the absence of positive blood cultures does not exclude an occult bacteraemia.…”

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

“…To accomplish this goal we need even better communication and collaboration between medical and dental colleagues, so that the practitioner can render the best treatment on the basis of the best available evidence and appropriate consultation(s). (38) Case report 5 Rubin et al (16) Case report 5 Ainscow and Denham (21) Prospective 4 Moderazo et al (39) Retrospective study 4 Jacobson et al (18) Retrospective study 4 Ching et al (20) Review 4 Waldman et al (14) Retrospective study 4 LaPorte et al (17) Retrospective study 4 Jaconbsen and Murray (19) Retrospective study 4 Uçkay et al (12) Systematic review 3 Seymour et al (40) Retrospective study 4…”

“…Jacobsen and Murray (19) investigated 1855 hip replacements and reported an incidence of 0.05% as possibly related to dental treatment. A review by Ching et al (20) reported 4 episodes of infection in joint replacement from among 110 patients to dental infection. Ainscow and Denham (21) followed 1000 patients with 1112 total joint replacements for a mean of 6 years.…”