Dental procedures as risk factors for prosthetic hip or knee infection: A hospital-based prospective case-control study

Elie F. Berbari, Douglas R. Osmon, Alan Carr, Arlen D. Hanssen, Larry M. Baddour, Doris Greene, Leo I. Kupp, Linda W. Baughan, W. Scott Harmsen, Jayawant Mandrekar, Terry M Therneau, James M. Steckelberg, Abinash Virk, Walter R. Wilson

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Abstract

Background. The actual risk of prosthetic joint infection as a result of dental procedures and the role of antibiotic prophylaxis have not been defined. Methods. To examine the association between dental procedures with or without antibiotic prophylaxis and prosthetic hip or knee infection, a prospective, single-center, case-control study for the period 2001-2006 was performed at a 1200-bed tertiary care hospital in Rochester, Minnesota. Case patients were patients hospitalized with total hip or knee infection. Control subjects were patients who underwent a total hip or knee arthroplasty but without a prosthetic joint infection who were hospitalized during the same period on the same orthopedic floor. Data regarding demographic features and potential risk factors were collected. Logistic regression was used to assess the association of variables with the odds of infection. Results. A total of 339 case patients and 339 control subjects were enrolled in the study. There was no increased risk of prosthetic hip or knee infection for patients undergoing a high-risk or low-risk dental procedure who were not administered antibiotic prophylaxis (adjusted odds ratio [OR], 0.8; 95% confidence interval [CI], 0.4-1.6), compared with the risk for patients not undergoing a dental procedure (adjusted OR, 0.6; 95% CI, 0.4-1.1) respectively. Antibiotic prophylaxis in high-risk or low-risk dental procedures did not decrease the risk of subsequent total hip or knee infection (adjusted OR, 0.9 [95% CI, 0.5-1.6] and 1.2 [95% CI, 0.7-2.2], respectively). Conclusions. Dental procedures were not risk factors for subsequent total hip or knee infection. The use of antibiotic prophylaxis prior to dental procedures did not decrease the risk of subsequent total hip or knee infection.

Original languageEnglish (US)
Pages (from-to)8-16
Number of pages9
JournalClinical Infectious Diseases
Volume50
Issue number1
DOIs
StatePublished - Jan 2010

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Cross Infection
Case-Control Studies
Hip
Knee
Tooth
Antibiotic Prophylaxis
Infection
Confidence Intervals
Odds Ratio
Joints
Knee Replacement Arthroplasties
Tertiary Healthcare
Tertiary Care Centers
Orthopedics
Logistic Models
Demography

ASJC Scopus subject areas

  • Infectious Diseases
  • Microbiology (medical)

Cite this

Berbari, E. F., Osmon, D. R., Carr, A., Hanssen, A. D., Baddour, L. M., Greene, D., ... Wilson, W. R. (2010). Dental procedures as risk factors for prosthetic hip or knee infection: A hospital-based prospective case-control study. Clinical Infectious Diseases, 50(1), 8-16. https://doi.org/10.1086/648676

Dental procedures as risk factors for prosthetic hip or knee infection : A hospital-based prospective case-control study. / Berbari, Elie F.; Osmon, Douglas R.; Carr, Alan; Hanssen, Arlen D.; Baddour, Larry M.; Greene, Doris; Kupp, Leo I.; Baughan, Linda W.; Scott Harmsen, W.; Mandrekar, Jayawant; Therneau, Terry M; Steckelberg, James M.; Virk, Abinash; Wilson, Walter R.

In: Clinical Infectious Diseases, Vol. 50, No. 1, 01.2010, p. 8-16.

Research output: Contribution to journalArticle

Berbari, EF, Osmon, DR, Carr, A, Hanssen, AD, Baddour, LM, Greene, D, Kupp, LI, Baughan, LW, Scott Harmsen, W, Mandrekar, J, Therneau, TM, Steckelberg, JM, Virk, A & Wilson, WR 2010, 'Dental procedures as risk factors for prosthetic hip or knee infection: A hospital-based prospective case-control study', Clinical Infectious Diseases, vol. 50, no. 1, pp. 8-16. https://doi.org/10.1086/648676
Berbari, Elie F. ; Osmon, Douglas R. ; Carr, Alan ; Hanssen, Arlen D. ; Baddour, Larry M. ; Greene, Doris ; Kupp, Leo I. ; Baughan, Linda W. ; Scott Harmsen, W. ; Mandrekar, Jayawant ; Therneau, Terry M ; Steckelberg, James M. ; Virk, Abinash ; Wilson, Walter R. / Dental procedures as risk factors for prosthetic hip or knee infection : A hospital-based prospective case-control study. In: Clinical Infectious Diseases. 2010 ; Vol. 50, No. 1. pp. 8-16.
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title = "Dental procedures as risk factors for prosthetic hip or knee infection: A hospital-based prospective case-control study",
abstract = "Background. The actual risk of prosthetic joint infection as a result of dental procedures and the role of antibiotic prophylaxis have not been defined. Methods. To examine the association between dental procedures with or without antibiotic prophylaxis and prosthetic hip or knee infection, a prospective, single-center, case-control study for the period 2001-2006 was performed at a 1200-bed tertiary care hospital in Rochester, Minnesota. Case patients were patients hospitalized with total hip or knee infection. Control subjects were patients who underwent a total hip or knee arthroplasty but without a prosthetic joint infection who were hospitalized during the same period on the same orthopedic floor. Data regarding demographic features and potential risk factors were collected. Logistic regression was used to assess the association of variables with the odds of infection. Results. A total of 339 case patients and 339 control subjects were enrolled in the study. There was no increased risk of prosthetic hip or knee infection for patients undergoing a high-risk or low-risk dental procedure who were not administered antibiotic prophylaxis (adjusted odds ratio [OR], 0.8; 95{\%} confidence interval [CI], 0.4-1.6), compared with the risk for patients not undergoing a dental procedure (adjusted OR, 0.6; 95{\%} CI, 0.4-1.1) respectively. Antibiotic prophylaxis in high-risk or low-risk dental procedures did not decrease the risk of subsequent total hip or knee infection (adjusted OR, 0.9 [95{\%} CI, 0.5-1.6] and 1.2 [95{\%} CI, 0.7-2.2], respectively). Conclusions. Dental procedures were not risk factors for subsequent total hip or knee infection. The use of antibiotic prophylaxis prior to dental procedures did not decrease the risk of subsequent total hip or knee infection.",
author = "Berbari, {Elie F.} and Osmon, {Douglas R.} and Alan Carr and Hanssen, {Arlen D.} and Baddour, {Larry M.} and Doris Greene and Kupp, {Leo I.} and Baughan, {Linda W.} and {Scott Harmsen}, W. and Jayawant Mandrekar and Therneau, {Terry M} and Steckelberg, {James M.} and Abinash Virk and Wilson, {Walter R.}",
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T1 - Dental procedures as risk factors for prosthetic hip or knee infection

T2 - A hospital-based prospective case-control study

AU - Berbari, Elie F.

AU - Osmon, Douglas R.

AU - Carr, Alan

AU - Hanssen, Arlen D.

AU - Baddour, Larry M.

AU - Greene, Doris

AU - Kupp, Leo I.

AU - Baughan, Linda W.

AU - Scott Harmsen, W.

AU - Mandrekar, Jayawant

AU - Therneau, Terry M

AU - Steckelberg, James M.

AU - Virk, Abinash

AU - Wilson, Walter R.

PY - 2010/1

Y1 - 2010/1

N2 - Background. The actual risk of prosthetic joint infection as a result of dental procedures and the role of antibiotic prophylaxis have not been defined. Methods. To examine the association between dental procedures with or without antibiotic prophylaxis and prosthetic hip or knee infection, a prospective, single-center, case-control study for the period 2001-2006 was performed at a 1200-bed tertiary care hospital in Rochester, Minnesota. Case patients were patients hospitalized with total hip or knee infection. Control subjects were patients who underwent a total hip or knee arthroplasty but without a prosthetic joint infection who were hospitalized during the same period on the same orthopedic floor. Data regarding demographic features and potential risk factors were collected. Logistic regression was used to assess the association of variables with the odds of infection. Results. A total of 339 case patients and 339 control subjects were enrolled in the study. There was no increased risk of prosthetic hip or knee infection for patients undergoing a high-risk or low-risk dental procedure who were not administered antibiotic prophylaxis (adjusted odds ratio [OR], 0.8; 95% confidence interval [CI], 0.4-1.6), compared with the risk for patients not undergoing a dental procedure (adjusted OR, 0.6; 95% CI, 0.4-1.1) respectively. Antibiotic prophylaxis in high-risk or low-risk dental procedures did not decrease the risk of subsequent total hip or knee infection (adjusted OR, 0.9 [95% CI, 0.5-1.6] and 1.2 [95% CI, 0.7-2.2], respectively). Conclusions. Dental procedures were not risk factors for subsequent total hip or knee infection. The use of antibiotic prophylaxis prior to dental procedures did not decrease the risk of subsequent total hip or knee infection.

AB - Background. The actual risk of prosthetic joint infection as a result of dental procedures and the role of antibiotic prophylaxis have not been defined. Methods. To examine the association between dental procedures with or without antibiotic prophylaxis and prosthetic hip or knee infection, a prospective, single-center, case-control study for the period 2001-2006 was performed at a 1200-bed tertiary care hospital in Rochester, Minnesota. Case patients were patients hospitalized with total hip or knee infection. Control subjects were patients who underwent a total hip or knee arthroplasty but without a prosthetic joint infection who were hospitalized during the same period on the same orthopedic floor. Data regarding demographic features and potential risk factors were collected. Logistic regression was used to assess the association of variables with the odds of infection. Results. A total of 339 case patients and 339 control subjects were enrolled in the study. There was no increased risk of prosthetic hip or knee infection for patients undergoing a high-risk or low-risk dental procedure who were not administered antibiotic prophylaxis (adjusted odds ratio [OR], 0.8; 95% confidence interval [CI], 0.4-1.6), compared with the risk for patients not undergoing a dental procedure (adjusted OR, 0.6; 95% CI, 0.4-1.1) respectively. Antibiotic prophylaxis in high-risk or low-risk dental procedures did not decrease the risk of subsequent total hip or knee infection (adjusted OR, 0.9 [95% CI, 0.5-1.6] and 1.2 [95% CI, 0.7-2.2], respectively). Conclusions. Dental procedures were not risk factors for subsequent total hip or knee infection. The use of antibiotic prophylaxis prior to dental procedures did not decrease the risk of subsequent total hip or knee infection.

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