American Academy of Orthopaedic Surgeons Appropriate Use Criteria: Prevention of Orthopaedic Implant Infection in Patients Undergoing Dental Procedures.

Abstract

Controversies exist regarding the appropriateness of antibiotic prophylaxis in patients undergoing a dental procedure following joint replacement surgery. The American Academy of Orthopaedic Surgeons has developed an Appropriate Use Criteria (AUC) for the Prevention of Orthopaedic Implant Infection in Patients Undergoing Dental Procedures. Evidence-based information, in conjunction with the clinical expertise of physicians, was used to develop criteria to determine the appropriateness of antibiotic prophylaxis to reduce the theoretical risk of post-surgical prosthetic joint infection in patients seeking dental care. The AUC algorithmic decision support tool was derived by identifying clinical indications typical of patients undergoing dental procedures following total knee or hip arthroplasty. Four patient scenarios and two treatment options were developed by the writing panel to cover appropriate scenarios related to this topic. Next, a separate, multidisciplinary voting panel rated the appropriateness of each scenario using a nine-point scale. The purpose of this article is to highlight the findings of this AUC and summarize the usage of the AUC for determining appropriateness of antibiotic prophylaxis for post-surgical joint replacement patients in various scenarios.