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New Guideline for the Prevention of Orthopaedic Implant Infection in Patients Undergoing Dental Procedures
American Dental Association (ADA) and the American Academy of
Orthopaedic Surgeons (AAOS) have released a new evidence-based guideline
on the Prevention of Orthopaedic Implant Infection in Patients
Undergoing Dental Procedures. The new guideline has three
recommendations and replaces the previous 2009 AAOS Information
Statement on Antibiotic Prophylaxis for Bacteremia in Patients with
on a collaborative systematic review of the scientific literature, the
AAOS and the ADA have found that the evidence does not support routine
prescription of antibiotic prophylaxis for patients with joint
replacement undergoing dental procedures. As described in the new
guideline, the AAOS-ADA recommendations are:
The practitioner might consider discontinuing the practice of routinely
prescribing prophylactic antibiotics for patients with hip and knee
prosthetic joint implants undergoing dental procedures.
We are unable to recommend for or against the use of topical oral
antimicrobials in patients with prosthetic joint implants or other
orthopaedic implants undergoing dental procedures.
In the absence of reliable evidence linking poor oral health to
prosthetic joint infection, it is the opinion of the work group that
patients with prosthetic joint implants or other orthopaedic implants
maintain appropriate oral hygiene.
AAOS and ADA have advised that these recommendations are not intended
to stand alone. Treatment decisions should be made in light of all
circumstances presented by the patient. Treatments and procedures
applicable to the individual patient rely on mutual communication
between patient, physician, dentist and other healthcare practitioners
in accordance with evidence based medicine applicability.
full guideline, executive summary, shared decision making tool and
other supporting documents are available from both websites of the AAOS (www.aaos.org) and the ADA (www.ada.org).
College's Quality Assurance Committee will be reviewing the new
AAOS-ADA guideline and members can expect to receive additional
information about this important subject in the new year