Preoperative dental assessment for the reduction of periprosthetic joint infections in patients undergoing total joint replacement: a systematic review and meta-analysis
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...
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Termedia Publishing House
2024-11-01
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| Series: | Anaesthesiology Intensive Therapy |
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| Online Access: | https://www.termedia.pl/Preoperative-dental-assessment-for-the-reduction-of-periprosthetic-joint-infections-in-patients-undergoing-total-joint-replacement-a-systematic-review-and-meta-analysis,118,55200,1,1.html |
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| author | Zbigniew Putowski Magdalena Miłobędzka Michał Kisiołek Wojciech Szczeklik Roman Jaeschke Piotr Puc Katarzyna Szczeklik |
| author_facet | Zbigniew Putowski Magdalena Miłobędzka Michał Kisiołek Wojciech Szczeklik Roman Jaeschke Piotr Puc Katarzyna Szczeklik |
| author_sort | Zbigniew Putowski |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-b9ade665d56240d89d8848504dbb9856 |
| institution | Kabale University |
| issn | 1642-5758 1731-2531 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Termedia Publishing House |
| record_format | Article |
| series | Anaesthesiology Intensive Therapy |
| spelling | doaj-art-b9ade665d56240d89d8848504dbb98562025-01-27T11:02:31ZengTermedia Publishing HouseAnaesthesiology Intensive Therapy1642-57581731-25312024-11-0156421722310.5114/ait.2024.14527855200Preoperative dental assessment for the reduction of periprosthetic joint infections in patients undergoing total joint replacement: a systematic review and meta-analysisZbigniew PutowskiMagdalena MiłobędzkaMichał KisiołekWojciech SzczeklikRoman JaeschkePiotr PucKatarzyna SzczeklikThe 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.https://www.termedia.pl/Preoperative-dental-assessment-for-the-reduction-of-periprosthetic-joint-infections-in-patients-undergoing-total-joint-replacement-a-systematic-review-and-meta-analysis,118,55200,1,1.htmldental care periprosthetic joint infection total joint arthroplasty |
| spellingShingle | Zbigniew Putowski Magdalena Miłobędzka Michał Kisiołek Wojciech Szczeklik Roman Jaeschke Piotr Puc Katarzyna Szczeklik Preoperative dental assessment for the reduction of periprosthetic joint infections in patients undergoing total joint replacement: a systematic review and meta-analysis Anaesthesiology Intensive Therapy dental care periprosthetic joint infection total joint arthroplasty |
| title | Preoperative dental assessment for the reduction of periprosthetic joint infections in patients undergoing total joint replacement: a systematic review and meta-analysis |
| title_full | Preoperative dental assessment for the reduction of periprosthetic joint infections in patients undergoing total joint replacement: a systematic review and meta-analysis |
| title_fullStr | Preoperative dental assessment for the reduction of periprosthetic joint infections in patients undergoing total joint replacement: a systematic review and meta-analysis |
| title_full_unstemmed | Preoperative dental assessment for the reduction of periprosthetic joint infections in patients undergoing total joint replacement: a systematic review and meta-analysis |
| title_short | Preoperative dental assessment for the reduction of periprosthetic joint infections in patients undergoing total joint replacement: a systematic review and meta-analysis |
| title_sort | preoperative dental assessment for the reduction of periprosthetic joint infections in patients undergoing total joint replacement a systematic review and meta analysis |
| topic | dental care periprosthetic joint infection total joint arthroplasty |
| url | https://www.termedia.pl/Preoperative-dental-assessment-for-the-reduction-of-periprosthetic-joint-infections-in-patients-undergoing-total-joint-replacement-a-systematic-review-and-meta-analysis,118,55200,1,1.html |
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