Risk of Infection UK TKR Patients

Hi, Jane, here in US I take 4 ampicillin prior to any dental work or so-called dirty procedures like gyno visit. I had a card from Dr for identifying the surgery. I just did four airline flights. Told security before he waved his magic wand that I had replacement knees. I was just directed go through the body scanner. They prostheses didn't even show up! I asked about that and the screener said it doesn't screen for metal. I didn't have any hassle, body search or anything. What a relief.

I am 5 mths TKR and have recently had a dental extraction on a wisdom tooth. I queried the need for AB prior to the extraction but I was informed that it is not practice now. I contacted my consultant who confirmed this. I had the tooth extracted and got an infection in the tooth and was promptly issued with a prescription for AB. Everything cleared up within three days and no problems occurred.

Hope that helps to answer your query.

Jackie x

I thought it was one but was corrected to two years post op that you need to take 2 grams of Keflex or some other antibiotic one hour before a dental procedure.  Your dentist writes the prescription.  They are very experienced in this as it's very common. One woman wrote that her doc told her she needed to do this for the rest of her life.  Never heard that before and cannot confirm it.

I'm the TSA's worst nightmare.  I go through the archway and light it up.  So they put me through the full body scanner.  Then I hear: "Hey Frank.  Ya gotta come over and see THIS guy!". Artificial hip and knee plus a fusion of L3 through S1.  Four and a half pounds of metal...it's like they've never see a Terminator before.

Kidding...  They just wand you and double check like Melinda noted.  Make sure you get up and walk around on the flight so the knee doesn't stiffen up.

Hi Jane,

At my six month check-up in December, my doctor told me that protocol had changed, and I don't need antibiotics before a dental appointment. However, this may be different for others based on their specific health conditions, so check with your doctor. Regarding air travel, I was told just to let security know that I have a knee replacement and they will do the body scan. My knee is feeling so good that I don't think about it much, and I couldn't figure out why I set off the alarm at a recent NBA game. After several minutes of checking , security finally  asked if I had any artificial joints. Embarrassed, I said, "Oh yes, my knee!" I think I'll remember next week at the airport 😜

Dentist sometimes refuse to do any work on TKR patients.

Hi 

My dentist refused to carry out an extraction for me because i had TKR.

Also you dont need a card at aiports because a body scanner will show up the prosthetic, unless of course you're in some small  airport that does not have an up-to-date scanner. 

Hmmm...  Antibiotics or no antibiotics.  Seems like everyone's got different information from none to lifetime.   So, without further ado, here's the latest from the American Dental Association...

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In 2014, the ADA Council on Scientific Affairs assembled an expert panel to update and clarify the clinical recommendations found in the 2012 evidence report and 2013 guideline, Prevention of Orthopaedic Implant Infection in Patients Undergoing Dental Procedures.1, 2

As was found in 2012, the updated systematic review undertaken in 2014 and published in 2015 found no association between dental procedures and prosthetic joint infections.  Based on this evidence review, the 2015 ADA clinical practice guideline states: "In general, for patients with prosthetic joint implants, prophylactic antibiotics are not recommended prior to dental procedures to prevent prosthetic joint infection.”

A co-published editorial by Meyer also states:

"The new CSA guideline clearly states that for most patients, prophylactic antibiotics are not indicated before dental procedures to prevent [prosthetic joint infections]. The new guideline also takes into consideration that patients who have previous medical conditions or complications associated with their joint replacement surgery may have specific needs calling for premedication. In medically compromised patients who are undergoing dental procedures that include gingival manipulation or mucosal inclusion, prophylactic antibiotics should be considered only after consultation with the patient and orthopedic surgeon. For patients with serious health conditions, such as immunocompromising diseases, it may be appropriate for the orthopedic surgeon to recommend an antibiotic regimen when medically indicated, as footnoted in the new chair-side guide."

The ADA encourages dental professionals to review the full 2015 guideline3 and take this recommendation into account, consult with the patient's orthopedic surgeon as needed, and consider the patient's specific needs and preferences when planning treatment. According to the ADA Chairside Guide, in cases where antibiotics are deemed necessary, it is most appropriate that the orthopedic surgeon recommend the appropriate antibiotic regimen and, when reasonable, write the prescription.

My surgeon said to be careful with chiropodists . . and that as a preventative measure antibiotics were a good idea, although it is no longer accepted in many countries as being essential. I did read an interesting article written by an official body in Canada, mentioning that if every TKR patient had antibiotics before every tooth extraction, the amount of antibiotics used would be enormous. H owever much I sympathise with national health systems struggling to cope with exc essive use of prescription drugs, I shall continue to use antibiotics before dental procedures, because it's my knee, and it would be me who had to have a revision if I got an infection. Of course, in 99.9 per cent of the cases there will be no infection. I just don't want to be that 0.01 per cent who gets it.