Dental Disease and Periprosthetic Joint Infection

Young, Heather; Hirsh, Joel M.; Hammerberg, E. Mark; Price, Connie S.

doi:10.2106/jbjs.l.01379

Cited by 51 publications

(40 citation statements)

References 52 publications

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“…Although all infections should be treated before TJA is performed, no relationship has been demonstrated between routine dental clearance and PJI incidence [5, 6]. Due to the lack of evidence regarding dental pathology as a source of PJI, only high-risk patients (such as tobacco and narcotic users, and patients who have not had a dental visit within the past 12 months) should be screened preoperatively for dental infection [7].…”

Section: Before the Day Of Surgerymentioning

confidence: 99%

The Prevention of Periprosthetic Joint Infections

Küçükdurmaz

Parvızı

2016

TOORTHJ

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Periprosthetic joint infection (PJI) following total joint arthroplasty (TJA) adversely affects patient quality of life and health status, and places a huge financial burden on the health care. The first step in combating this complication is prevention, which may include implementation of strategies during the preoperative, intraoperative, or postoperative period. Optimization of the patient with appreciation of the modifiable and non-modifiable factors is crucial. Preoperative optimization involves medical optimization of patients with comorbidities such as diabetes, anemia, malnutrition and other conditions that may predispose the patient to PJI. Among the intraoperative strategies, administration of appropriate and timely antibiotics, blood conservation, gentle soft tissue handling, and expeditious surgery in an ultra clean operating room are among the most effective strategies. During the postoperative period, all efforts should be made to minimize ingress or proliferation of bacteria at the site of the index arthroplasty from draining the wound and hematoma formation. Although the important role of some preventative measures is known, further research is needed to evaluate the role of unproven measures that are currently employed and to devise further strategies for prevention of this feared complication.

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Section: Before the Day Of Surgerymentioning

confidence: 99%

The Prevention of Periprosthetic Joint Infections

Küçükdurmaz

Parvızı

2016

TOORTHJ

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“…Indeed, 6% to 13% of PJIs are caused by oral flora. 5 In a series by LaPorte et al, 11 the authors showed that up to 6% of PJIs were closely related to recent dental procedures. However, the most common pathogens for PJIs are coagulase-negative staphylococci, Staphylococcus aureus , streptococcus species, gram-negative rods, enterococcus species, and anaerobes.…”

Section: Discussionmentioning

confidence: 99%

“…6 Coagulase-negative staphylococcus and S aureus are common skin flora and account for 30% to 43% and 12% to 23%, respectively, of PJIs. 5 About 30% of the population is colonized with S aureus . 11 The prevalence of PJI after findings of staphylococcus bacteremia has been reported to be between 34.1% to 37.9%.…”

Section: Discussionmentioning

confidence: 99%

“…11 The prevalence of PJI after findings of staphylococcus bacteremia has been reported to be between 34.1% to 37.9%. 5,12,13 Notably, however, the inoculum of bacteria that is required to cause a PJI is unknown. Zimmerli 6 found that 46 to 210 colony-forming units per milliliter (CFU/mL) injected into the region of a tissue cage in guinea pigs was required to induce infection in >95% of the animals.…”

Section: Discussionmentioning

confidence: 99%

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Prosthetic Joint Infections in Patients Undergoing Carpal Tunnel Release

Zeng

Paul

Kemp

et al. 2017

J Am Acad Orthop Surg

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Introduction Little information is available regarding the rate of prosthetic joint infections (PJIs) in patients undergoing carpal tunnel release (CTR) without antibiotic prophylaxis. Hand surgeons should be aware of patients’ history of arthroplasty. Methods All patients who underwent CTR at our institution between 2012 and 2014 were identified and their charts were reviewed to identify those who had a history of total hip, knee, and/or shoulder arthroplasty. Further chart review consisted of identifying a history of PJI, use of perioperative antibiotics, and surgeon awareness of prior arthroplasty. Results Two hundred seventy-five CTR surgeries were performed in patients who had previously undergone total joint arthroplasty (TJA). There were no PJIs in any group of patients (P = 0.01). Hand surgeon awareness of the presence of an arthroplasty history had no discernable effect on the choice to use antibiotics. Conclusions There was a 0% rate of PJI in our series of patients with a history of TJA who underwent CTR. Overall hand surgeon awareness of TJA status was poor or poorly documented. Routine prophylactic antibiotics may not be indicated in patients undergoing CTR, even with the presence of a prosthetic joint.

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“…21 Given the considerable costs, morbidity, and mortality associated with these infections, and the fact that dental procedures are known to induce transient bacteremia, 16,22 the use of prophylactic antibiotics by orthopedists before dental procedures became widespread in the 1970s. 23 However, the data supporting this practice proved to be limited.…”

Section: Dental Proceduresmentioning

confidence: 99%

Antibiotic Prophylaxis for Patients with a History of Total Joint Replacement

DeFroda

Lamin

Gil

et al. 2016

The Journal of the American Board of Family Medicine

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As the population ages and people remain active into the 7th and 8th decades of life, the frequency of total joint replacement is increasing. Following joint replacement surgery, patients inevitably require various invasive procedures as part of their routine health maintenance, including, but not limited to, dental care, colonoscopy, cystoscopy, and cardiac catheterization. There is scant evidence to support the use of periprocedural prophylactic antibiotics in the prevention of late total joint infection. The guidelines for the usage of periprocedural antibiotics have changed as knowledge of the pathophysiology of joint infection has evolved. We review the current recommendations from subspecialty academic organizations regarding antibiotic prophylaxis for patients undergoing routine urologic, gastrointestinal, dental, and cardiac procedures after total joint replacement. (J Am Board Fam Med 2016;29:500 -507.)

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Dental Disease and Periprosthetic Joint Infection

Cited by 51 publications

References 52 publications

The Prevention of Periprosthetic Joint Infections

The Prevention of Periprosthetic Joint Infections

Prosthetic Joint Infections in Patients Undergoing Carpal Tunnel Release

Antibiotic Prophylaxis for Patients with a History of Total Joint Replacement

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