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Bacteria in the gums may contribute to artificial hip & knee joint replacement failure

Bacteria associated with gum disease may relocate to the joints and cause hip or knee prosthesis failure, according to researchers from Case Western Reserve University School of Dental Medicine.

"For a long time, we've suspected these bacteria were causing problems in arthritis patients, but never had the scientific evidence to support it," Nabil Bissada, DDS, MSD, of the department of periodontics at the Western Reserve University School of Dental Medicine, stated in an university news release.

The researchers suggest the findings may explain why aseptic loosening or prosthetic wear of artificial joints occurs within 10 years when no infection appears to be present. The findings were reported in the Journal of Clinical Rheumatology.

The researchers looked for oral bacterial DNA in the synovial fluid of 36 patients with arthritis, periodontal disease and either native or clinically aseptically failed prosthetic joints, according to the abstract. Twenty-five patients had osteoarthritis (OA) and 11 patients had rheumatoid arthritis (RA). The researchers reported failed prostheses in eight OA patients and one RA patient.

Bacterial DNA was collected from the synovial fluid of hip and knee joints. The researchers also gathered pooled subgingival samples and examined the patients for periodontal disease. The investigators found bacterial DNA in the synovial fluid of 13.9% of patients - two RA patients (one native knee, one failed prosthesis) and three OA patients (one native knee, two failed prostheses).

"We have a link now and want to see just how much of a trend this is," Bissada stated. "We also will be able to see if treating the periodontal disease can reduce the future of costly joint replacements."

For more information about periodontal disease, please click here.

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