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Meta-Analysis
. 2024;56(4):217-223.
doi: 10.5114/ait.2024.145278.

Preoperative dental assessment for the reduction of periprosthetic joint infections in patients undergoing total joint replacement: a systematic review and meta-analysis

Zbigniew Putowski  1 , Magdalena Miłobędzka  2 , Michał Kisiołek  3 , Wojciech Szczeklik  1 , Roman Jaeschke  4 , Piotr Puc  5 , Katarzyna Szczeklik  6
Affiliations
Meta-Analysis

Preoperative dental assessment for the reduction of periprosthetic joint infections in patients undergoing total joint replacement: a systematic review and meta-analysis

Zbigniew Putowski et al. Anaesthesiol Intensive Ther. 2024.

Abstract

The requirement for preoperative dental assessment (PDA) to prevent periprosthetic joint infection (PJI) after total joint arthroplasty (TJA) seems to be a common practice at least in some orthopaedic centres. There are few studies which have examined this intervention. Routine referral of patients for routine PDA increases costs and potentially prolongs the time to the procedure. In order to investigate the effect of PDA on the frequency of PJI after TJA, we conducted a systematic review with meta-analysis of observational studies including adult patients undergoing TJA. The search for eligible studies was performed across MEDLINE, EMBASE, Web of Science, and Google Scholar databases. The intervention group consisted of patients who had undergone PDA, while the control group consisted of patients without PDA. The main outcome was the presence of PJI. In addition to traditional meta-analysis, a Bayesian analysis and trial sequential analysis were performed. The analysis included five observational studies. Considering PJI as an outcome, the total risk of bias was assessed as serious. A total of 23 175 patients were included in those studies, of whom 12 324 had a PDA. There was no effect of PDA versus no PDA on the incidence of PJI (OR 0.86, 95% CI: 0.50-1.49; I² = 42%). Bayesian analysis showed that the posterior probability of PDA reducing the frequency of PJI was 69.1%. Thus it was concluded that, in patients undergoing TJA, it remains unknown whether PDA influences the occurrence of postoperative PJI. There is insufficient evidence to support performing this intervention routinely. The health care systems and individual organisations will likely need to make decisions on continuation of such programmes on the basis of this limited amount of information.

Keywords: periprosthetic joint infection; total joint arthroplasty; dental care.

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Conflict of interest statement

none.

Figures

FIGURE 1
FIGURE 1
Systematic selection flowchart
FIGURE 2
FIGURE 2
Risk of bias assessment
FIGURE 3
FIGURE 3
Random-effect meta-analysis
FIGURE 4
FIGURE 4
Effect of preoperative dental assessment for the reduction of periprosthetic joint infection. Bayesian meta-analysis, weakly informative normal prior. Posterior probability of effect: 69.1%
See this image and copyright information in PMC

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References

    1. Masutani R, Pawar A, Lee H, Weissman JS, Kim DH. Outcomes of common major surgical procedures in older adults with and without dementia. JAMA Netw Open 2020; 3: E2010395. DOI: 10.1001/jamanetworkopen.2020.10395. - DOI - PMC - PubMed
    1. Tsaras G, Osmon DR, Mabry T, Lahr B, St Sauveur J, Yawn B, et al. . Incidence, secular trends, and outcomes of prosthetic joint infection: a population-based study, Olmsted County, Minnesota, 1969-2007. Infect Control Hosp Epidemiol 2012; 33: 1207-1212. DOI: 10.1086/668421. - DOI - PMC - PubMed
    1. Weinstein EJ, Stephens-Shields AJ, Newcomb CW, et al. . Incidence, microbiological studies, and factors associated with prosthetic joint infection after total knee arthroplasty. JAMA Netw Open 2023; 6: e2340457. DOI: 10.1001/jamanetworkopen.2023.40457. - DOI - PMC - PubMed
    1. Aggarwal VK, Rasouli MR, Parvizi J. Periprosthetic joint infection: current concept. Indian J Orthop 2013; 47: 10-17. DOI: 10.4103/0019-5413.106884. - DOI - PMC - PubMed
    1. Indelli PF, Iannotti F, Ferretti A, et al. . Recommendations for periprosthetic joint infections (PJI) prevention: the European Knee Associates (EKA)–International Committee American Association of Hip and Knee Surgeons (AAHKS)–Arthroplasty Society in Asia (ASIA) survey of members. Knee Surg Sports Traumatol Arthrosc 2022; 30: 3932-3943. DOI: 10.1007/s00167-021-06742-1. - DOI - PubMed

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