noura
new member
- Joined
- Dec 3, 2013
- Messages
- 18
- Age
- 55
- Country
- United States
- Gender
- Female
I am posting this on behalf of my mother who had a TKR in her left knee in July 2015. Everything went well and she recovered gradually from her surgery, until 2 months back which pain started abruptly in her knee. She lives outside the US and had her surgery in Germany but she is visiting me here and her pain started while she is visiting.
Xrays of the knee showed some kind of bone fracture. But also knee aspiration showed high WBC count (5000), although as I see from the results normal should be <200. Also something called SEG SYN (a test of the synovial fluid) had a value of 87 (normal <20). Although I took her here to one of the top hospitals in US, the OS shook his head and was very blunt about it. He indicated that she has infection but her surgery is very complicated that he does not recommend revision surgery. Her first surgery was complicated in the first place where a special "hinged" implant was used because she has RA and her ligaments were not strong to support the knee. We were told this kind of implant is only used in Europe. The implant is deeper in the bone that a regular implant. The OS indicated that it is a risky surgery that he does not recommend. He made it sound that she is doomed if she chose to undergo the surgery and doomed if she did not. And mentioned all kinds of horrible outcomes.
My mother does not have insurance here and most probably we will not be able to perform the surgery here, however, I want to act on this quickly if she truly has an infection and we want some advice. Isnt it strange that the OS would not recommend anything and just send her back home? I feel me and my mother very stuck in a situation where we do not know what to do next. Her physician in Germany indicated from looking at xrays that she needs revision surgery with bigger implant. We can travel to Germany to see him but I want to make sure that it is indeed infected so I have the following questions:
1- Shall I look for another OS or Infection disease specialist.
2- Based on the results above, I am not sure if she definitely has an infection or we need to redo the test or make different ones. Based on my research I found those additional tests:
- Alpha defensin test
- WBC tagged bone scan
3- The OS told her that it is a chronic infection. Other than pain that is very bearable for her right now, and some swelling, I do not see any other symptoms. How soon do we need to act on this? Also would taking oral antibiotics make it any better or slow down progress of infection?
Xrays of the knee showed some kind of bone fracture. But also knee aspiration showed high WBC count (5000), although as I see from the results normal should be <200. Also something called SEG SYN (a test of the synovial fluid) had a value of 87 (normal <20). Although I took her here to one of the top hospitals in US, the OS shook his head and was very blunt about it. He indicated that she has infection but her surgery is very complicated that he does not recommend revision surgery. Her first surgery was complicated in the first place where a special "hinged" implant was used because she has RA and her ligaments were not strong to support the knee. We were told this kind of implant is only used in Europe. The implant is deeper in the bone that a regular implant. The OS indicated that it is a risky surgery that he does not recommend. He made it sound that she is doomed if she chose to undergo the surgery and doomed if she did not. And mentioned all kinds of horrible outcomes.
My mother does not have insurance here and most probably we will not be able to perform the surgery here, however, I want to act on this quickly if she truly has an infection and we want some advice. Isnt it strange that the OS would not recommend anything and just send her back home? I feel me and my mother very stuck in a situation where we do not know what to do next. Her physician in Germany indicated from looking at xrays that she needs revision surgery with bigger implant. We can travel to Germany to see him but I want to make sure that it is indeed infected so I have the following questions:
1- Shall I look for another OS or Infection disease specialist.
2- Based on the results above, I am not sure if she definitely has an infection or we need to redo the test or make different ones. Based on my research I found those additional tests:
- Alpha defensin test
- WBC tagged bone scan
3- The OS told her that it is a chronic infection. Other than pain that is very bearable for her right now, and some swelling, I do not see any other symptoms. How soon do we need to act on this? Also would taking oral antibiotics make it any better or slow down progress of infection?