Antibiotic Prophylaxis in Patients with Total Joint Arthroplasty before Dental Procedures: Systematic Review and Meta-analysis
Bibliographic record
Abstract
Abstract Background: Total joint arthroplasty (TJA) is followed by periprosthetic joint infection (PJI). At present, PJI is observed to have a rate of incidence of 1% to 2% in total knee arthroplasty (TKA) patients and 0.3%–2.9% in total hip arthroplasty (THA) patients. LaPorte et al . in 1999 observed that in individuals who have had THA, PJI may result from temporary bacteraemia that occurs after a dental operation. Bacteraemia from dental procedures has the potential to infect distant areas, especially prosthetic implants. Antibiotic prophylaxis for individuals undergoing dental procedures who have THA or TKA is also controversial because the pathophysiology is unclear. We conducted a systematic review and meta-analysis due to insufficient evidence regarding the benefits and potential risks of giving prophylactic antibiotics before dental procedures for patients with TJA and a non-infectious oral condition. Methods: We systematically checked four databases (PubMed, Cochrane Library, Scopus and Web of Science) for any relevant studies till 3 March 2024. In the studies that were considered, individuals who had undergone dental procedures after having undergone hip or knee arthroplasty were examined to see whether there was a correlation between dental procedures and PJI. The risk of bias was assessed using two tools. Newcastle–Ottawa Scale for cohort and case–control studies. National Institutes of Health tool for case series. Results: Seven included studies, four of which were case series, two were cohort and one was case control. Our analysis of the case series revealed a non-significant relationship between dental procedures and PJI. The proportion was 0.07 (95% confidence interval [CI] 0.04; 0.12). These results were supported by analysis of infection among prophylactic and non-prophylactic patients. The odds ratio was 1.1 (95% CI 0.65; 1.85, P = 0.72) indicating a non-significant difference between the two groups. Conclusion: We found that antibiotics do not provide infection coverage in patients with TJA. Therefore, there is no need for antibiotics before dental procedures.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".