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Old 01-02-2020, 05:04 PM
 
746 posts, read 407,536 times
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Quote:
Originally Posted by gentlearts View Post
A theory was that it had something to do with a colonoscopy he had a few months after the hip replacement. The infection was a type of E. coli, but they dont know for sure how it wound up in his hip. He had to wear an IV and a penicillin pump for 6 weeks. Not fun. Thankfully, it worked.
OMG how awful for him - and you! What an ordeal to have to endure and am glad that those 6 long weeks of treatment paid off and he was cured of the infection. Thanks for sharing that.
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Old 01-03-2020, 09:01 AM
 
Location: equator
4,456 posts, read 1,943,649 times
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I remember hearing about this also. (I have 2 knees and hip replacements). But I think I forgot when I had crowns done 2 years ago! Before, for just a cleaning, it seems like the dentist said it wasn't necessary.

I feel your pain, as I cannot for the life of me, find ANY info online about what NOT to do for the rest of your life after replacements. There is only info on immediately after the surgery.

I would probably take a couple days' worth of antibiotics to be on the safe side. They gave me 3 days worth after my dislocation.
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Old 01-03-2020, 10:33 AM
 
Location: Haiku
6,375 posts, read 3,193,752 times
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I would not rely on anecdote to solve this, I would rely on statistical studies.

According to a 1997 study by the NIH, about 1% of people who have total knee replacement will subsequently have a late (more than 6 months later) infection that is associated with an invasive dental procedure, and most of those were by people who had systemic problems such as diabetes.

So if ALL the following are true:
- You have a compromised immune system or other systemic problems
- You had a joint replacement
- You are going to have dental surgery (not just a filling or teeth cleaning)
- Than you may benefit by AB prophylaxis

https://www.ncbi.nlm.nih.gov/pubmed/9345222
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Old 01-03-2020, 12:36 PM
 
746 posts, read 407,536 times
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Thanks for that info 2x4. I think I'd seen that article in my travels, but good refresh on the data.

After some more digging around and reading various studies done from 2003 to date, I found this article that may be of use for those like me looking for recent info on this issue (from 2017): https://www.mdedge.com/internalmedic...ificial-joints

This pretty much sums up what other studies said and that I suspected to be true - that ABs before dental work is really are not necessary for healthy people with joint replacements. Infection risk also seems to be highly dependent on the strain of bacteria exposure.

Here is an important point I came across that everyone should know. Prophylactic cleaning is one of the highest risk dental procedures for joint replacement (under 2 years). I would have thought that this procedure would be relatively low risk, since it usually isn't very invasive; but apparently not so. This is great motivation to up your dental hygiene to keep your gums as healthy as possible since this is where all the baddies live.

So my final conclusion? I definitely WILL be doing the anti-biotics, until I read that Orthopedic and Dental Associations come to agreement concerning the use of pre-dental AB prophylaxis for healthy individuals. Since it's only for one day (2 pills) and I tolerate them well, why not? At least if things go pear-shaped, I can at least be assured that I did everything within my power to avoid infection. After that, it's out of my hands.

Last edited by BijouBaby; 01-03-2020 at 12:52 PM..
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Old 01-03-2020, 01:57 PM
 
Location: Coastal Georgia
38,535 posts, read 47,419,225 times
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Quote:
Originally Posted by BijouBaby View Post
OMG how awful for him - and you! What an ordeal to have to endure and am glad that those 6 long weeks of treatment paid off and he was cured of the infection. Thanks for sharing that.
To make matters worse, we had to fly to Puerto Rico for my son’s wedding. TSA was a challenge and so was having the penicillin shipped ahead and kept cold. Then, in the final week, DH developed hives, so now he’s allergic to penicillin. Thankfully, the 5 weeks were enough.
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Old 01-03-2020, 02:02 PM
 
Location: on the wind
8,935 posts, read 3,902,858 times
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Quote:
Originally Posted by BijouBaby View Post
Prophylactic cleaning is one of the highest risk dental procedures for joint replacement (under 2 years). I would have thought that this procedure would be relatively low risk, since it usually isn't very invasive; but apparently not so. This is great motivation to up your dental hygiene to keep your gums as healthy as possible since this is where all the baddies live.
Actually it makes sense to me that dental cleanings pose the highest risk. The hygienist is disturbing every soft tissue surface around every tooth in your mouth, not to mention scraping around and dislodging tartar/plaque, they're not just looking at it. During a more focused dental repair they are only disturbing the tooth that needs work, maybe the one on either side. Plus there's the simple statistical probability that you'll probably have more cleanings over time than you would other work. The more of them you do, the higher the risk.
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Old 01-05-2020, 07:19 AM
 
Location: Bella Vista, Ark
73,826 posts, read 86,279,759 times
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Quote:
Originally Posted by BijouBaby View Post
I have experienced varying guidance on whether or not to take an antibiotic an hour prior to any dental procedure after any joint replacement. Even the 3 Ortho surgeons that I interviewed prior to my TKR all said different things.

My surgeon said I must take 2 antibiotic pills prior to any dental work for the rest of my life. Another said only for the first 2 years, then none after that. A third said it was not necessary to take an AB prior to dental work.

I've read that the Canadian and American Dental Associations have dropped condoning antibiotic prophylaxis for dental work following joint replacements, but Ortho surgeons generally don't agree, so there is now a conflict of advice from the two professional organizations that is very confusing for the patient. My dentist was neutral on the topic and said he'd do whatever I prefer (indicating to me that he doesn't personally feel it's necessary). I decided on the conservative path and will follow my surgeon's protocol for antibiotic prophylaxis prior to getting my teeth cleaned next month. This will be the first dental work I've had done since my TKR 8 months ago and am kind of nervous. I wonder if taking the antibiotic practically guarantees no joint infection?

For instance, a friend's husband has had 2 TKRs by the same surgeon and she claims the surgeon never told them to do anything special with dental appointments and he's had many in the years since his replacements with no problems. I was shocked that she never heard of this!

So I'd really like to hear from those that have had joint replacements - do you follow this protocol of antibiotic prophylaxis prior to dental work? And if so, are you doing it for a limited time (like just in the first 2 years), or do you plan to do it for the rest of your life? Any out there that have never taken AB's prior to dental work, nor plan to do it in the future, with no resulting issues.

Last question - have you or anyone you know ever gotten an infection due to dental work following their joint replacement, whether antibiotic prophylaxis was practiced or not? I'm trying to get a sense of how common contracting an infection from dental work is.

Research on the internet has been very confusing and conflicting, so I'd like to hear some personal experiences of people on this forum. Thanks!
Don't know of anyone who has gotten an infection, but it certainly won't hurt to take an antibiotic for safety reasons. I had to take one or at least it was suggested for 2 years after knee replacement. It certainly didn't cause me any problems.
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Old 01-06-2020, 04:42 AM
 
Location: The Driftless Area, WI
3,273 posts, read 1,275,559 times
Reputation: 7226
Quote:
Originally Posted by BijouBaby View Post
I wonder if taking the antibiotic practically guarantees no joint infection?

!

Absolutely not. Nothing in Nature is 100% predictable.


As others have said- it's always a matter of risks vs benefits. The cost, inconvenience & possible side effects of taking the prophylaxis is negligible, and even tho the probability of an infection is low, the damage from one is huge. It's good insurance.


Do you need a helmet when you drive a motorcycle? NO!... (unless you fall off)
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Old 01-06-2020, 09:30 AM
 
Location: NJ
11,978 posts, read 22,183,246 times
Reputation: 10735
My last L5S1 fusion with rods and screws in August 2006, I was on antibiotics every time I saw the dentist, not just for cleanings, for 2 years. I thought it was stupid, especially since I was younger and healthier.

I sure wouldn't do it for life. Antibiotics are bad to take unless needed. It's why we have so many super bugs
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Old 01-11-2020, 08:42 PM
 
1,776 posts, read 2,431,483 times
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I am someone who had a knee replacement get infected. No fault of the surgery, but I knelt on the hard stone floor in the kitchen because the idiot handyman could not figure out how to fix the kitchen sink drain. Popped a leak in the incision that was not yet fully healed over.

Despite dressing by the surgeon and 2x/day antibiotics the knee got a raging infection soon after.

This meant:

1. Knee replacement was removed and an antibiotic impregnated cement spacer installed. Non weight-bearing and leg immobilized. Because staph lives in metal my "buzz box" heart device was also removed and a new one installed on the other side.

2. Transferred to a skilled nursing facility for the administration of an antibiotic drip 3x/day. Left leg totally useless and got pretty weak.

3. 6 weeks of the antibiotic drip regimen and then two more weeks at home to be observed that the infection was really gone.

4. Finally I got the knee replacement done all over again. This is significantly more invasive than it was the first time and the original surgeon called in a big gun who specializes in revision surgeries.

I did not want to second guess this specialist. He said put off dental cleaning till 4 months and take antibiotic pill before and that is what I did.

I did NOT want to take any chances. The two months killing time was got really old. Much better now that I can work on my rehab and I'm doing good. Rehab after a revision is somewhat slower than it was the first time, (as far as I got).

I would err on the side of caution and go with your orthopedic surgeon.

And I hope your rehab is going well!

Don
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