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Knee & Hip Problems Message Board


Knee & Hip Problems Board Index


Hi. I just scheduled my hip replacement surgery for August 4. And, then was entertained by a coworker with a gruesome story of a relative who had an infection from another injury result in horrific problems with a jointreplacement. {I think maybe I have to start being careful who I talk to before I actually have my surgery! The bad stories are just ssoooooo awful...)

I've read in other places, and on this board, that we need to always notify the dentist that we have joint replacements and take antibiotics before any dental procedure. But, it appears that if you develop any infection even a bladder infection, cuts, boils and dental absesses that you have to get treatment immediately. These infections can travel via your bloodstream to the rplacement.

As far as I can tell viral infections like colds and sore throats aren't a problem. Has anyone been told differently?

I'm assuming too that if you have to have any other procedure that you might need an antibiotic--so rule of thumb should be to tell every doctor that treats you that you have a joint replacement.

So, am wondering--are these concerns for the life of the implant (assuming so) or has anyone been told there's a time limit. (I have read in some places, for example, that you need to take antibiotics before dental work for 2 or 3 years, but other places say its for life. Haven't seen anything to say that other procedures require antibiotics for only a limited time).

Maggie
Yes, I believe that most surgeons would advise you to resolve all dental issues that require invasive treatment before hip replacement. You need to go into surgery with a "clean" mouth. Consult with your dentist to see what work you need to have done, then with the surgeon to get his take on the matter.
Hi. I just received an information packet from my doctor and it states that it is imperative that you have any dental work done prior to surgery. This will include any extractions, filings or any type of treatment for infections in your mouth. If you don't take care of oral health prior to surgery, it could cause delay or possible cancellation of surgery because any mouth or gum infection could be a potential source of concern for your prosthesis following your surgery! So, you should definitely go to the dentist!
I'm scheduled for hip replacement on Feb. 18, and the information that the nurse gave me at my last appt. 2 days ago (stuck in my hand as he ran out the door, in inimitable HMO style) says to have dental work done four weeks *prior* to surgery--the first anybody told me about that timeline. The surgeon said I should get dental work done when I saw him first a month ago, but there is a fair amount to do and the dentist will still be doing root canal work this week and next. I left a phone message for the HMO and am waiting to hear back--anybody know if this is going to be an issue? The preparations for this surgery are so elaborate (my sister flying in from out of state, my four college classes getting covered by four other teachers, arrangements for my dog), that I *really* don't want to have to postpone the whole thing--
I was told no dental work, two weeks prior to surgery, no dental work, even cleaning, three months after surgery.

I understand that one's overall oral hygiene is a key factor. I try to keep my gums and mouth in order and will have to even more so now.

Also, I developed pneumonia in the rehab..fever one day after surgery, 102+, and then pneumonia with fever that lasted till I went home from rehab. I was treated with Avalox profilatically in the rehab, to ward off bacterial pneumonia.

I have asthma too, and received albuterol treatments in rehab, but really needed steroids. They allowed my breathing to be somewhat lower than usual to avoid steroids since they lower resistance to infection.

When I came home, I went on steroid dose pak and my breathing got better.

Then I developed a very slight infection from ingrown toenail from wearing heavy socks with wrong shoes in rehab and home. So back on antibiotics for 10 days.

My problem is I caught C-Diff in the hospital in 06 and almost died with it. Was there for weeks. So for past three years every time I take even one antibiotic pill I have to take flagyl for prevention of recurrence of C-Diff.
I also need Diflucan now since I get oral/esophageal thrush from the flagyl. The Nystatin no longer works.

I am going to see an infectious disease specialist end of this month. It is seven weeks since my hip replacement.

I need a plan for all of this premedicating...do I need flagyl still??

Also, I am diabetic, in good control, no meds, no insulin, good weight. I will probably get my nails cut every 9 weeks (allowed by Medicare) by my podiatrist. If I have no infection and it is a routine nail clipping, can I NOT premedicate. I just called surgeon about this.

I had a tooth bonding done this week and had premedicated for it and for cleaning and just because I ran into a woman in the office who had her hip replaced four months ago, I learned about the no-teeth-cleaned rule for three months. I called surgeon from dentist.

DO NOT GET TEETH cleaned for at least three more months.

Just now I got a call from surgeon's office. If I get routine nail clippings, no infection, no premedication is needed. That's good.

Now I have to find out about colonoscopy. Some say yes, some say no...will ask surgeon at next visit.

Too many antibiotics can lead to C-Diff...which can be deadly. I hope I never get it again.

Thanks everyone for sharing your information.

Some surgeons want pre-meds for life, some for two to three years....I plan to follow my surgeon's advice. I don't want a sepsis in my hip...I plan to err on the side of precaution and keep myself as infection free as possible.

terri





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