AAOS Clinical Practice Guideline Summary Prevention of Total Hip and Knee Arthroplasty Periprosthetic Joint Infection in Patients Undergoing Dental Procedures
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Updated: Sep 13, 2025

Novel Diagnostics in Revision Arthroplasty: Implant Sonication and Multiplex Polymerase Chain Reaction
Published on: December 3, 2017
Charles P Hannon1, Matthew J Grosso, Yale A Fillingham
1From the Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN (Hannon), the Department of Orthopedic Surgery, University of Connecticut School of Medicine, Farmington, CT and the Quality and Research, Connecticut Joint Replacement Institute at Saint Francis, Hartford, CT (Grosso), the Thomas Jefferson University and the Rothman Orthopaedic Institute, Philadelphia, PA (Fillingham), the Division of Craniofacial and Surgical Care and is the Adams School of Dentistry General Practice Residency, The University of North Carolina of Chapel Hill Adams School of Dentistry, Chapel Hill, NC (Patton).
Abstract:
The Prevention of Total Hip and Knee Arthroplasty Periprosthetic Joint Infection in Patients Undergoing Dental Procedures Evidence-Based Clinical Practice Guideline is based on a systematic review of published studies examining the influence of dental care and procedures on outcomes after total joint arthroplasty (TJA) as well as strategies to mitigate potential risks associated with dental care and procedures in patients with a TJA. The scope of this guideline includes the role of dental screening, antibiotic prophylaxis, use of antimicrobial mouth rinses, and timing of dental procedures before and after TJA. The population was limited to patients with total hip arthroplasty (THA) or total knee arthroplasty because of a paucity of data on patients with other orthopaedic implants. Based on the best current available evidence, this guideline contains five options to assist all qualified clinicians, including orthopaedic surgeons and dental providers, considering the prevention of total hip arthroplasty and total knee arthroplasty periprosthetic joint infections in patients undergoing dental procedures. It is also intended to serve as an information resource for professional healthcare practitioners and developers of practice guidelines and recommendations. In addition to providing pragmatic practice recommendations, this guideline also highlights gaps in literature and informs areas for future research and quality measure development.
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