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TKR Is a decayed tooth really needed to be pulled before TKR

Att52

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I have been waiting for over 30 years to have my right knee replaced. I was told I was too young. Wait until I'm 55. But I am now bone on bone at age 52. My ortho had me scheduled to replace my knee, but then refused because I have a deep decay in one tooth. I've already had all upper teeth pulled. I'm really not concerned about this one tooth. I need this knee done Now. Is it really necessary to get this tooth pulled before surgery?
 

Jaycey

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@Att52 Welcome to BoneSmart! Your surgeon is concerned about the tooth as there is a risk of infection. It's unlikely that the infection could reach your knee but there is a risk. Many surgeons require dental clearance before joint replacement.

Is your dentist willing to do the treatment as soon as possible?
 
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Att52

Att52

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@Att52 Welcome to BoneSmart! Your surgeon is concerned about the tooth as there is a risk of infection. It's unlikely that the infection could reach your knee but there is a risk. Many surgeons require dental clearance before joint replacement.

Is your dentist willing to do the treatment as soon as possible?
He said he want to wait another 6 weeks After my tooth is pulled. I've retained another ortho for my surgery. It doesnt make sense to me because I would be put on antibiotics once the knee is replaced, so there wouldn't be an infection from my tooth, correct???
 

Celle

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I think you have to follow your surgeon's requirements, or you're not going to get that knee replacement.

While you may be given antibiotics in the first 24 hours after surgery, most surgeons no longer give a full course of antibiotics as a precautionary measure. Giving antibiotics prophylactically (just in case) is now not recommended, as it has been one of the reasons why we now have a proliferation of antibiotic-resistant bacteria.
 

lovetocookandsew

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IMHO, I'd take care of the tooth before the surgery. While it may be unlikely the infection will spread to your new knee, why take the chance?
I had some work done on a tooth once which somehow got infected afterwards. That infection spread all throughout my body, even into my neck where I've had bone grafts and a titanium plate put in, into my back and down to my ankle. I ended up in the hospital for a week on two major antibiotics plus another six or eight weeks at home; the spine surgeon who did the neck fusion almost had to go in and clean that area out, but luckily the antibiotics cleared it up in my neck, if not my ankle. I had to have the infection in my ankle, and the problems it caused, surgically cleaned up by my OS. Now, I take antibiotics before dental work; not due to the knee implant, but due to the infection I had that no one wants me to go through again. I know it's rare but I'm taking no chances.

If your surgeon wants your tooth taken care of first, I'd get it done and wait the six weeks he requires. I know it's hard to wait when in pain, but the silver lining is you can use the six weeks to get super ready for your down time during recovery.
 

pdlinda

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@Att52
I had a tooth extracted prior to my TKR as my surgeon (apparently like yours) refused to do the surgery with any infection whatsoever in my body.

in 4 months I will have an implant procedure done to replace the extracted tooth.

Good Luck!!
 

eaglemom

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Interesting how each surgeon has their own protocol. My surgeon is, in his own words, overly cautious where dental work is concerned. No dental work or cleaning 4 weeks prior to surgery and absolutely no dental work for 6 months. Yes 6 months. I ask "why" and his answer was I've been doing this a long time and with those two simple rules I've never had a patient have as issue. That's good enough for me.

Personally I'd have to dental work done first. I'm not that much of a gambler on 'what if' that could happen. Waiting stinks, but its so much better than an infection, IMO.
 

Julia1911

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YES, it must be addressed first. I have to take antibiotics before dental cleanings due to a heart issue because the bacteria get in your blood stream.

I had a 6 month cleaning scheduled 4 days after knee surgery. I called my dentist to reschedule (as I knew I wouldn't be up to getting it so soon after surgery) and he told me to check with my ortho to see what kind of window I should schedule around my dental work. My dentist (he has siblings who are medical doctors) told me the orthos ususally want any dental work completed at least 2 weeks before the joint replacement surgery.

Lo and behold, I called my ortho and they said YES, get the dental work all cleared up at least 2 weeks before surgery to avoid any bacteria floating around in your bloodstream.
 

Celle

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@Att52 - How are you getting on? You haven't come back to respond to some of the advice you've been given.

I doubt that you will find any responsible surgeon willing to undertake joint replacement while you have a known source of infection in your body - and you do want a responsible surgeon, don't you?

That deep dental decay could flare up into an abscess at any time, so get that tooth treated as soon as possible and stop wasting time looking for a surgeon who will do what you want..
 

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