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New guidelines reconsider antibiotic use in TJA patients undergoing routine dental procedures

The American Academy of Orthopaedic Surgeons and American Dental Association have released a statement concluding that orthopedic surgeons should reconsider antibiotics for total joint arthroplasty patients undergoing routine dental procedures, as there is no direct evidence these procedures will cause periprosthetic joint infection.

“It has been long debated that patients with orthopedic implants, primarily hip and knee replacements, are prone to implant infections from routine dental procedures,” David S. Jevsevar, MD, MBA, chair of the American Academy of Orthopaedic Surgeons (AAOS) Evidence Based Practice Committee overseeing development of the clinical practice guidelines, stated in a press release. “What we found in this analysis is that there is no conclusive evidence that demonstrates a need to routinely administer antibiotics to patients with an orthopedic implant who undergo dental procedures.”

 

David S. Jevsevsar

The joint guidelines from AAOS and the American Dental Association stated that, based on limited evidence, prophylactic antibiotics and oral topical antimicrobials did not prevent periprosthetic joint infection (PJI). However, the guidelines recommend good oral hygiene due to lack of evidence linking poor oral health with PJI.

“As clinicians, we want what is in the best interest of our patients, so this clinical practice guideline is not meant to be a stand-alone document,” Jevsevar said. “Instead, it should be used as an educational tool to guide clinicians through treatment decisions with their patients in an effort to improve quality and effectiveness of care.”

Reference:
www.aaos.org/Research/guidelines/PUDP/PUDP_guideline.pdf

Disclosure: Jevsevar has no relevant financial disclosures.