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Is it Important to Take an Antibiotic Before Dental Procedures or other Invasive Procedures if I have a Total Joint Replacement?

Posted Mar 22 2010 1:01pm
The American Academy of Orthopaedic Surgeons released an information statement reinforcing the need to take prophylactic antibiotics when having dental work or other invasive procedures.  This recommendation comes from the fact that deep infections of total joint replacements are very costly, both financially and emotionally for the patient due to the need for extensive revision surgery and staged treatment. Patients often do not have normal use of the infected joint until the revision process and surgery is completed, which can be 3-6 months and in some cases longer.  Revision surgery due to infection affects both the patient's quality of life as well as can be a significant financial burden due to time off work.  

Due to the disastrous consequences of infection in a total joint replacement, it is highly recommended to take prophylactic antibiotics.  "It is likely that bacteremia associated with acute infections in the oral cavity, skin, respiratory, gastrointestinal, and urogenital systems and/or other sites can and do cause late implant infections.  Patients with total joint replacements who are having invasive procedures are at an increased risk of hematogenous seeding of their prosthesis."  Therefore, the American Academy of Orthopaedic Surgeons recommends that clinicians consider antibiotic prophylaxis for all total joint replacement patients prior to any invasive procedure that may cause bacteremia.  Invasive procedures include dental cleaning, Orthopaedic, vascular, gastrointestinal, head and neck, obstetric and gynecological, and genitourinary procedures.  The first dose must be given at least 60 minutes before the procedure so that an effective dose is present in the tissues before the procedure begins.  Antibiotic prophylaxis is recommended in most patients, but must be examined on a case-by-case basis.

February 2009 American Academy of Orthopaedic Surgeons Information Statement.  http://www.aaos.org/
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