Can Gum Disease Affect Your Knee Replacement?

Researchers have found periodontal bacteria in periprosthetic joint infections of the knee, according to a new study published in the Journal of Applied Biomaterials and Functional Materials.

Periodontal bacteria Treponema denticola and Enterococcus faecalis were found in the joints of patients who had already undergone knee replacement surgeries. These bacteria are most often associated with periodontal disease but T. denticola in particular has been associated with several systemic conditions, most recently Alzheimer’s disease.

These infections were exclusive to the knee—researchers found no trace in any hips, ankles, elbows, or shoulders. Further investigation into the severity of infection and level of penetration of the bacteria suggests that periodontal bacteria may travel via the blood stream from the mouth to the knee, where infection and damage can then occur.

Interestingly, researchers also found T. denticola and E. faecalis in patients undergoing initial arthroplasty surgery—in other words, infections of periodontal bacteria in osteoarthritic knees do not appear to be exclusive to those that have undergone knee replacements.

Does this mean that periodontal bacteria contribute directly to the development of osteoarthritis, or do they just make an existing condition worse? The study authors concluded that more investigation into this relationship is needed, but the possible implications for the prevention and treatment of osteoarthritis are significant. When we look past the face value and get upstream of some of our most common afflictions, many are being found to have a bacterial component.

Last year at the American Academy for Oral Systemic Health’s 3rd Annual Scientific Session, Dr. Dan Sindelar interviewed this study’s lead researcher Dr. Garth Ehrlich about some of his research into the bacterial components of osteoarthritis. “I think the biggest paradigm shift is that many of the conditions that we used to think of as chronic inflammatory conditions are actually chronic bacterial infections,” said Dr. Ehrlich.

And, indeed, much research has been done in recent years into the bacterial components of some of the most common inflammatory diseases—cardiovascular disease, diabetes, rheumatoid arthritis, and even Alzheimer’s—inciting a shift in mindset when it comes to preventing, diagnosing, and treating these diseases.

Source: What role do periodontal pathogens play in osteoarthritis and periprosthetic joint infections of the knee?