The American Academy of Orthopaedic Surgeons (AAOS), and the American Dental Association (ADA) found that there is insufficient evidence to recommend the routine use of antibiotics for patients with orthopaedic implants to prevent infections prior to having dental procedures because there is no direct evidence that routine dental procedures cause prosthetic joint infections.
The AAOS and ADA's recommendations are based on a collaborative evidence-based clinical practice guideline that focuses on the possible linkage between orthopaedic implant infection and patients undergoing dental procedures.
"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. 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," said David Jevsevar, MD, MBA, chair of the AAOS Evidence Based Practice Committee which oversees the development of clinical practice guidelines.
"It has been long debated that patients with orthopaedic implants, primarily hip and knee replacements, are prone to implant infections from routine dental procedures," added Dr. Jevsevar who also is an orthopaedic surgeon in St. George, Utah. "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 orthopaedic implant, who undergo dental procedures.
Elliot Abt, DDS, MS, MSc, who served as member of the AAOS-ADA work group on behalf of the ADA, pointed out that the review committee conducted a thorough review of existing clinical research published in the peer-reviewed literature.