Are Antibiotics Required Before Dental Work After Total Knee Replacement
The topic of prophylactically using antibiotics after knee replacement before dental work remains controversial. Link
This 2016 publication in Arthroplasty Today, suggests “Current international guidelines do not support the use of antibiotic prophylaxis to prevent PJI [prosthetic joint infection].”
Who Orders the Antibiotics After Knee Replacement Before Dental Work
Surgeon
If antibiotics are required before dental procedures are performed during the first 12 months, the surgeon will commonly write the prescription.
Patients are often scheduled for a 12-month follow-up after rehabilitation is complete. Anything related to the total knee replacement during this 12-month episode often goes through the orthopedic surgeon.
Dentist
In some cases, the dentist will order the prescribed antibiotics. In my experience, local dentists will order the antibiotics if the orthopedic surgeon is unavailable or there is some other reason the patient is unable to secure the prescription from the orthopedic surgeon that performed the surgery.
If the dentist requires antibiotics beyond 12 months after surgery then the dentist will order the prescription or ask the patient to contact the primary care physician.
Primary Care Physician
In rare cases when the dentist or surgeon is not able to order the antibiotic treatment, the primary care physician may be asked to get involved.
Tips for Patients Planning a Total Knee Replacement
- Scheduling a dental cleaning and consult before scheduling a total knee replacement may help identify any future oral complications
- Some surgeons recommend patients complete any dental work before scheduling a total knee replacement.
- Some surgeons recommend waiting for 3 to 6-months after surgery to have invasive dental work.
