The Association of Dental Caries or Dental Implant Placement Within One Year of Primary Total Hip Arthroplasty on Medical and Implant Complications

Adam M Gordon; Mitchell K Ng; Matthew L Magruder; Jake M Schwartz; Che Hang Jason Wong; Michael A Mont

doi:10.1016/j.arth.2024.04.047

The Association of Dental Caries or Dental Implant Placement Within One Year of Primary Total Hip Arthroplasty on Medical and Implant Complications

J Arthroplasty. 2024 Apr 20:S0883-5403(24)00370-X. doi: 10.1016/j.arth.2024.04.047. Online ahead of print.

Authors

Adam M Gordon¹, Mitchell K Ng², Matthew L Magruder², Jake M Schwartz², Che Hang Jason Wong², Michael A Mont³

Affiliations

¹ Maimonides Medical Center, Department of Orthopaedic Surgery, Brooklyn, New York; Questrom School of Business, Boston University, Boston, MA.
² Maimonides Medical Center, Department of Orthopaedic Surgery, Brooklyn, New York.
³ Rubin Institute of Orthopaedic Surgery, Department of Orthopaedic Surgery, Baltimore, Maryland. Electronic address: rhondamont@aol.com.

PMID: 38649065
DOI: 10.1016/j.arth.2024.04.047

Abstract

Introduction: Total hip arthroplasty (THA) adverse events among patients who have dental diagnoses remain unclear. We sought to determine if dental caries or dental implant placements increased: 1) 90-day medical complications; 2) 90-day readmissions; and 3) 2-year implant-related complications, including periprosthetic joint infections (PJIs) after THA.

Methods: A nationwide database for primary THAs from 2010 to 2021 was queried to compare three patient cohorts. Patients who had a history of dental implants or caries within 12 months prior to THA (n = 1,179) or 12 months after THA (n = 1,218) were case-matched to patients who did not have dental history (n = 6,090) by age and comorbidities. Outcomes included 90-day complications, 90-day readmissions, and 2-year implant-related complications. Logistic regression models computed the odds ratios (OR) of complications and readmissions. P values less than 0.006 were significant.

Results: Patients who had dental caries or implant placement 12 months before or after THA experienced 1.6-fold greater odds of 90-day medical complications compared to case-matched patients. Readmissions within 90 days increased for patients who had a dental history before (11.7 versus 8.3%; OR: 1.49, P < 0.0001) and after (14.2 versus 8.3%; OR: 1.84, P < 0.0001) THA compared to case-matched patients. A dental caries diagnosis or dental implant placement within 12 months following THA increased 2-year implant complications compared to case-matched patients (15.2 versus 9.3%; OR: 1.69, P < 0.0001), including PJIs (5.3 versus 2.8%; OR: 1.98, P < 0.0001), dislocations (4.4 versus 2.7%; OR: 1.63, P = 0.002), and THA revisions (3.9 versus 2.5%; OR: 1.61, P = 0.005).

Conclusion: Dental diagnoses within 12 months of THA are associated with increased medical complications. Dental diagnoses occurring 12 months after THA are associated with greater implant-related complications, including PJIs. Delaying invasive dental procedures for 12 months after THA may be advisable.

Keywords: Complications; Database; Dental Work; Infection; Oral Hygiene; Outcomes; Periprosthetic Joint Infections; Total hip Arthroplasty.