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Knee & Hip Problems Message Board

Knee & Hip Problems Board Index

As you have deduced from your coworker's gruesome story, infection on the prosthesis is one of the more devastating complications of hip replacement. I also have an acquaintance who was without hips for a year because there was infection in both hip replacements and they were removed until the infection cleared up.

You are correct that it isn't viral colds and flu that cause worry. From my reading it is dental procedures that have the greatest potential for seeding bacteria onto the prosthesis where they can find a happy home and create a "slime" that the body's immune system can't fight. The ADA and the AAOS have issued a joint statement that presents what they agree on with regard to premedicating before dental procedures. Other possible culprits: urological infections and GI endoscopic procedures to name two. The recommendations for premedication may vary depending on the doctor, the amount of time that has passed since the surgery, other health problems that the patient has.

My hip replacements took place 5 & 6 years ago. I still premedicate before any dental procedure that is invasive ( would puncture my gum or draw blood) which is just about everything including cleanings, fillings, extractions, etc.). I'm currently scheduled for a colonoscopy (an endoscopic procedure of the bowel) and I'm going to see what the surgeon's take is on my need for antibiotics. If he says that I don't need antibiotics I will call the ortho surgeon's office and get his opinion. Some protocols call for premedicating for the first 2 years after surgery since this is when the risk is at it's highest. So far my surgeon has kept prescribing it for my dental appts. and my dentist considers that I will need this for life and will prescribe it even if the ortho surgeon doesn't. Interestingly, from my reading, one thing to watch out for is skin infections. A small cut can easily be ignored but, untreated, it can allow infection into the bloodstream. So the advice is - if your skin is broken by a cut or abrasion, don't ignore it. Wash it, put on disinfectant and a bandaid.

To be fair, some studies have shown that there may be as much risk from the antibiotics that are administered (allergic reactions, etc.) as there is from the bacteria. I can attest to this because I took amoxicillin before dental appointments (because of a heart murmur) for 20 years without incident and then suddenly developed a severe allergic reaction (full body rash but no anaphylactic shock). I was told that I can never take that antibiotic again. I use a different drug now. So far, no bad reactions.

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