Related Experiment Video
Updated: Jul 2, 2025
10:35
Novel Diagnostics in Revision Arthroplasty: Implant Sonication and Multiplex Polymerase Chain Reaction
Published on: December 3, 2017
11.2K
Antibiotic Prophylaxis Prior to Dental Procedures After Total Hip and Knee Arthroplasty Does Not Decrease the Risk of
Samantha J Simon1, Alya A Aziz1, Gloria S Coden1
1Department of Orthopaedic Surgery, New England Baptist Hospital, Boston, Massachusetts.
The Journal of Arthroplasty
|February 24, 2024
Summary
Routine antibiotics before dental procedures do not reduce the risk of periprosthetic joint infection (PJI) after hip or knee replacement. This study found no association between antibiotic prophylaxis and late-onset PJI, suggesting it is unnecessary.
Area of Science:
- Orthopedic surgery
- Infectious disease
- Public health
Background:
- Periprosthetic joint infection (PJI) is a serious complication following total hip and knee arthroplasty (THA/TKA).
- Current guidelines question routine antibiotic prophylaxis for dental procedures, yet many surgeons still prescribe them for THA/TKA patients.
- Reducing unnecessary antibiotic use is crucial due to rising antibiotic resistance.
Purpose of the Study:
- To evaluate the use of antibiotics prior to dental procedures in THA/TKA patients.
- To determine the association between dental procedures and the risk of developing PJI.
Main Methods:
- Retrospective cohort study of THA/TKA patients from January 2019 to December 2020.
- Primary outcome: late-presenting PJI (>90 days post-surgery).
- Patients categorized into antibiotic (amoxicillin 2,000 mg) or no-antibiotic groups based on surgeon protocol; dental-associated PJI defined by poor dentition or recent dental work.
Main Results:
- 2,871 patients (26.4%) received no antibiotics; 8,023 (73.6%) received antibiotics.
- A total of 27 (0.3%) late-presenting PJIs were observed; 4 were dental-associated.
- All 4 dental-associated PJIs occurred in patients who received antibiotics; however, multivariable analysis showed only BMI ≥30 and revision surgery increased PJI risk.
Conclusions:
- The rate of late-presenting PJI was low in this cohort.
- Routine antibiotic prophylaxis before dental procedures did not demonstrate a significant effect on the risk of late-presenting PJI.
- Findings suggest routine antibiotic prophylaxis is not necessary for THA/TKA patients undergoing dental procedures.
