Causes Of Joint Infection
A total joint can possibly become infected starting at the time of surgery, or can range from a few short weeks after or up to several years after recovery time is over and the surgery is completed. Common ways that bacteria can enter the body includes minor cuts or breaks in the skin, root canals, tooth extractions or other major dental procedures, and through wounds that are the result of other surgical procedures.
Certain people will face a higher risk for developing infections after any surgical procedure including a joint replacement procedure. Factors that will play a role in the increase the risk of infection includes:
- Diabetes mellitus
- Fevers, night sweats, and chills
Other Ways Joints Become Infected
Following joint replacement surgery, the blood flow to the joint increases for a period of time, as the body is healing. Along with the metal and plastic parts, which have no immune system, this increased blood flow can carry bacteria from the blood stream to the replaced joint. If the bacteria reach the implants, they may stick and create an infected joint.
Bacteria can be carried by our blood stream because of severe illnesses, such as sepsis. However, more commonly, bacteria may transiently get carried through the blood, and the body clears it without any obvious illness, unless it gets carried to the replaced joint. This is why infections can occur in replaced joints even decades after the surgery.
If you get a bacterial infection in the body, it is a good idea to see your primary care doctor. Colds, flus, or other viral infections do not require antibiotics. However, if you get a cut that looks worrisome or a redness in the legs or urinary infections or other bacterial infections in the body, your primary care doctor may need to treat these with antibiotics.
Certain medical procedures can increase the risk of pushing bacteria into the blood stream, such as dental work, abdominal surgery, or colorectal procedures. It is important to take antibiotics prior to these procedures.
What Is The Typical Recovery Time For A Hip Replacement
According to Thakkar, hip replacement patients generally return to work in two to four weeks, but they vary greatly. You can have your knee replaced based on a number of factors, including how active you were prior to the operation, your age, nutrition, preexisting conditions, and other factors affecting your health and lifestyle.
Hip Replacement Surgery: How To Make A Successful Recovery
Following hip replacement surgery, you will need to place a raised toilet seat in your own toilet at home. While sitting, it is critical that your knees are not elevated above your hips. Constipation can be prevented by drinking plenty of fluids and eating foods high in fiber, such as fruits and vegetables. If you havent had any bowel movement within two to three days while taking pain medications, use a stool softener and a laxative.
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Why Your Dental Health Matters
Researchers are increasingly uncovering the role that your dental health plays in your overall health. As examples, one study found that those who brush their teeth fewer than two times a day and for less than two minutes were three times more likely to develop heart disease. Another study found a link between periodontitis and dementia.
The reason why these areas of your health are connected is that when you have gum disease, harmful bacteria can enter your bloodstream. This is an overly simplistic explanation for a complex issue, but it gives you a basic idea of what were up against.
While periodontitis is one of the primary culprits, any time you have an infection in your mouth, such as a root canal infection or even dental caries , it means that infection-causing bacteria are present in your system.
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Hip Replacement Surgery Checklist
Hip replacement surgery involves a long recovery time to allow your body to heal. Learn about steps to take before the procedure to keep you healthy and minimize post-op problems.
Before Hip Replacement Surgery: Working With Your Orthopedist
The most important thing you can do before surgery is to make sure you are comfortable with your orthopedic surgeon.
You need a doctor you can talk to and trust to get a sense of where things are, advises Steven Stuchin, MD, director of orthopedic surgery at the Hospital for Joint Diseases of New York University Medical Center and associate professor at the NYU School of Medicine in New York City.
Because you will most likely go through years of follow-up, choose a surgeon you feel youll be able to work with for a long time.
Before Hip Replacement Surgery: Medical Evaluation
Prior to your hip replacement, you will be evaluated by your primary care doctor to make sure you are healthy enough for surgery. This evaluation might include an electrocardiogram, chest X-ray, and blood tests, and making sure chronic conditions such as asthma or high blood pressure are under control. Your medical doctor will use this information to determine whether youre at high risk for complications due to surgery.
Before Hip Replacement Surgery: Blood Transfusion
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Heart Problems That Call For Antibiotics In Dental Procedures
Virtually all guideline committees around the world recommend antibiotic prophylaxis for those individuals at high risk of an adverse outcome from infective endocarditis and who are undergoing invasive dental procedures. Today, the AHA only recommends antibiotics before dental procedures for patients with the highest risk of infection, those who have:
If youre not sure about the guidelines for your heart condition, check with your heart specialist. If you have one of these conditions, always tell your dentist. Also, alert your dentist if â you are allergic to any antibiotics or other medications.
Is A Hip Replacement A Major Operation
Because hip replacement is a major surgery, only if other treatments, such as physiotherapy and steroid injections, have not improved mobility or pain relief is it appropriate to have it done.
Hip Replacement Surgery: A Major Procedure That Can Be Completed In Just Two Hours
The hip has been replaced. The incision is closed using stitches. Hip replacement surgery can be completed in a matter of hours. An incision is made in the hip, passing tissue from one layer to the next. After the surgeon has removed the diseased and damaged bone and cartilage, the healthy bone is allowed to heal. Following the new hip has been installed, a stitched opening is created in the incision. After the surgery is finished, the patient is likely to be able to resume their normal activities.
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The Importance Of Good Dental Health Before Your Orthopaedic Surgery
While you may think theres little connection between your teeth and gums and your hip joint, there are times when these two areas of your health meet. More specifically, if youre planning to undergo hip replacement surgery, we recommend that you get cleared by your dentist beforehand to lower your risk for postoperative infection.
At Western Orthopaedics, our hip specialist, Dr. Brian White, understands that your road to deciding to replace your hip joint was a tough and painful one. Our goal is to put an end to your discomfort, so we want to make sure that everything goes as smoothly as possible. As part of this effort, ensuring that your teeth and gums are infection-free certainly helps.
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Keeping The Mouth Clean
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How To Decrease The Risk Of Joint Replacement Infections
About 1 milliontotal joint replacement surgeries mostly hips and knees are performed each year across the country. In most cases, the new prosthetic hip or knee offers significant pain relief and, with regular physical therapy, patients can get back to their daily life quickly. In about 1% of cases, however, patients develop a deep infection.
Bacteria can enter the joint during the procedure, even in a sterile operating room, or after it, as the incision heals. A third option is that bacteria already present in the patients body travel through the blood to the site of the prosthesis. This is the type of infection that doctors and dentists are working together to prevent.
Joint Replacement Infection Causes & Symptoms
Hip and knee joint replacement surgeries are one of the most successful surgeries in the history of modern medicine. The surgeries relieve the pain and disability caused by arthritis not amicable by conservative management options. But like all surgeries, there is are risks of a number of complications after any hip or knee joint replacement surgery. The infection of the artificial joint is one of the dreaded complications of joint replacement.
The risk of infection after joint replacement surgery is roughly about 1% . The chances of infection are significantly higher in the case of revision surgery. The infection may develop in the tissues around the artificial joint or over the wound.
The infection may occur immediately in the hospital or after the patient goes home. Joint replacement infections may also develop years after the procedure.
X-ray showing infected hip prosthetic joint.
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How Soon After Hip Replacement Can I Have A Colonoscopy
There is no definitive answer to this question as it depends on the individuals healing process and recovery. However, most doctors typically recommend waiting at least six to eight weeks after hip replacement surgery before having a colonoscopy. This allows the incision to heal properly and reduces the risk of complications.
Dental Treatment Hip Surgery And Antibiotics
There has been debate for years about whether or not antibiotics should be given to patients who have had a hip replcement, and who then need dental treatment. My advice has been to take a broad spectrum antibiotic such as augmentin if you are to have an extraction, or treatment of an abscess. Routine dental treatment such as a filling or scale and polish doesnt require any prophylactic antibiotics. Recent statements from the American Academy of Orthopaedic Surgeons and NICE suggest that there is no evidence that antibiotics make any difference to the risk of developing a joint replacement infection. Ive attached a summary of the relevant article for information. If you are in doubt, speak to your surgeon and dentist Good oral hygiene is essential in patients with joint replacements and I advise my patients to see a dentist if they havent had a check up for a year before undergoing surgery.
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Why Cant You Get Dental Work After Hip Replacement
There are a few reasons why you cant get dental work after hip replacement. The first reason is that the surgery itself can cause damage to your teeth. The second reason is that the anesthesia can cause your teeth to become loose. Finally, the recovery process can be very difficult and can cause your teeth to become even more loose.
Before undergoing surgery, you should have completed any dental work you have already done. By doing so, you will be able to reduce the risk of infections entering your bloodstream.
Getting Your Body Ready
Taking good care of your body is a necessary step prior to having joint replacement surgery. If there are unnecessary risks, your surgery may need to be canceled or postponed. Taking care of yourself now will help minimize issues later and shorten recovery time.
- We recommend you see your dentist at least one month before surgery to ensure that you dont have any dental infections or problems that could delay your surgery. Have all dental work completed, including routine cleaning, at least one month prior to surgery to allow sufficient time for healing and to minimize the risk of infections.
- Avoid cuts, rashes, or scratches from pets. If there is a risk for infection, you may need to cancel or postpone your surgery.
- On the evening prior to surgery, it is a good idea to cleanse your body using anti-bacterial soap. You will also be asked to wipe down your body with Chlorohexidine wipes on the day of your surgery to decrease the overall bacteria on your body.
- On the day of surgery, you will be given a dose of antibiotics which will continue 24 hours after surgery. These antibiotics fight bacteria that may get into your blood stream.
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To What Extent Do We Find Staphylococci In The Oral Cavity
There is considerable controversy as to whether Staphylococcus species play a role in the ecology of the normal oral flora, and there is surprisingly little knowledge on the role of staphylococci in oral health and disease. It has been claimed that S. aureus and S. epidermidis constitute only 0.005% of the oral microbiota . However, a growing body of evidence suggests that staphylococci can be isolated more frequently from the oral cavity of some patient groups such as children , elderly , terminally ill patients , rheumatoid arthritis patients , and patients with hematological malignancies . Therefore, the oral cavity may represent a hitherto poorly recognized reservoir of staphylococci, which under the right conditions may cause local or systemic infection .
Significantly higher proportions of staphylococci were recovered from periimplantitis lesions compared to gingivitis and periodontitis , and it was suggested that staphylococci may play a role in some failing osseointegrated dental implants . Another study with 37 patients with failing implants detected staphylococci, organisms associated with the gut and Candida species in 55% of peri-implant lesions and almost as frequently as periodontopathogens . Implants surrounded by healthy periodontium had a microflora compatible with microbial health.
S. aureus has further been recovered from jaw cysts and oral mucosal lesions .
Do You Need Antibiotics Before Your Dental Visit
Antibiotics treat bacterial infections. Antibiotic prophylaxis is the taking of antibiotics before a surgery or other procedure that may release large numbers of bacteria into your bloodstream to decrease the chance of infection in another part of your body. During dental procedures that may cause bleeding, such as tooth extractions, large numbers of bacteria from the mouth can enter the bloodstream. In persons at high risk of infection or with certain heart conditions, there is concern that these bacteria may cause infection in other parts of the body . The immune system normally kills these bacteria, but antibiotic prophylaxis may offer these people extra protection. The American Heart Association recommends that antibiotics be used prior to some dental procedures for persons with certain heart conditions, who may be at risk for developing an infection of the heart.
Numerous studies have pointed out that blood bacteria may occur during normal daily activities, such as chewing, tooth brushing and flossing. It is likely that these daily activities induce many more bacteremias than typical dental procedures. While studies do show a strong association between certain dental procedures and bacteremia, they dont show good evidence that there is a direct link between dental procedure associated bacteremia and infections in the heart or prosthetic joints.
Heres what the experts say.
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Good Dental Health Is Key To Overall Health
Prevention is always the best medicine. Its much easier to treat an issue in its earliest stages than to treat it once it has become a severe problem. Preventing tooth loss, dangerous complications, and related diseases is possible with good oral health habits. Thats why we always recommend regular brushing, flossing, and dental cleanings.
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If Youve Had Joint Replacement You May Need Antibiotics Before Dental Work
If youve had a total joint replacement or similar procedure, you will want your surgeon to decide if you need to take an antibiotic before you undergo dental work. This is a precaution to prevent a serious infection known as bacteremia.
Bacteremia occurs when bacteria become too prevalent in the bloodstream and cause infection in other parts of the body, especially in joints and bone with prosthetic substances. Its believed that during invasive dental procedures bacteria in the mouth can enter the bloodstream through incisions and other soft tissue disruptions.
Joint infections are a serious matter and can require extensive therapy to bring it under control. Out of this concern, the use of antibiotics as a prophylactic against bacteremia once included a wide range of patients for a variety of conditions and procedures. But after an in-depth study in 2007, the American Dental Association concluded that the risks for many of these patient groups for infection triggered by a dental procedure was extremely low and didnt warrant the use of antibiotic premedication therapy.
The guidelines for antibiotic premedication can be complex. Its best, then, to speak with both your orthopedic surgeon and us about whether you should undergo antibiotic therapy before you undergo a dental procedure. The ultimate goal is to reduce the risks of any disease and to keep both your mouth and your body safe from infection.
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