Maisybo
junior member
I'm new here & thought I'd post about my dilemma in hopes of getting some advice or information.
I had right TKR August 2014. I have lymphedema in both legs but my ortho didn't think it would be a problem.
Each year since my TKR, my knee has gotten warm, red, painful & swollen, requiring surgery to clean out.. The 1st & 2nd times the surgeries were minor; not much pain, & doctor/ortho surgeon said "no evidence of infection in the hardware". I had to do Vancomycin & Zosin IV for 6 weeks after surgery & PT, & after 2nd surgery, infectious disease doctor had me take oral Bactrim 1600 mg daily for a year.
Yet, just as my year of oral antibiotics came to an end, in September of 2017 my knee was red & swollen yet again...I also have Crohn's Disease, & take Entocort orally for that.
My surgeon drew some of the pus-like fluid from my knee to culture it, & nothing grew on the culture. He said it was because I'd been on Bactrim for a year. So my ortho had to take me to surgery a 3rd time to debride my knee. This time he put antibiotic beads in there. When I woke up in recovery I was in agony. I was sure he had taken out the implant because of the amount of pain I had, but he hadn't. The anesthesiologist had to do a nerve block in recovery for me to have some relief because the morphine wasn't helping at all...it was horrible.
My ortho said there was no biofilm on the implant so it was not infected, so didn't need to be removed, but if my knee developed another abscess, he would have to go in & remove the implant, put in spacers for 6 weeks, & then do another TKR. I had 6 weeks of Vancomycin IV afterward & PT.(Medicare is my insurance at this point & wouldn't pay for Zosin, too; for the previous surgeries I had private insurance).
About 6 weeks ago after I did an hour on my compression pants lymphedema pump machine, I noticed yellowish fluid running down my leg. So I pressed a little on my knee, & a whole bunch of it started pouring out. It didn't look like pus, it's a watery consistency, & I'm taking 1600 mg of oral Bactrim daily again, per infectious disease doctor. It drained for about a day from a tiny opening at the bottom of the incision from my September surgery, & then started draining again yesterday.
I don't know how my ortho can tell if these abscesses are being caused by the lymphedema in my legs or by infected hardware?
I just had 16 decayed teeth extracted 2 weeks ago; my ortho & infectious disease doc said the decay could have caused the knee abscesses & to have the decayed teeth removed asap, & Dec 4 was as soon as I could afford it.
I DO NOT want to have this implant removed & another placed if this is from the lymphedema!! It will just keep happening if that's what's causing it, right? I'm emotionally drained from all this going on for 4 years, & it seems there may be no end...
I'm seeing an ortho who specializes in implant complications within the next few weeks for a 2nd opinion, but since my knee is draining again, wondering if I just need to go to my regular ortho... I know he will say implant has to come out...
Has anyone else gone through this or anything similar?
I feel like I'm going to have a breakdown over all this! I'm disabled & live alone & have some support from my sister, but not much.
I would really appreciate any advice or comments you can offer; I appreciate your input & I know this was a long post; sorry.
I had right TKR August 2014. I have lymphedema in both legs but my ortho didn't think it would be a problem.
Each year since my TKR, my knee has gotten warm, red, painful & swollen, requiring surgery to clean out.. The 1st & 2nd times the surgeries were minor; not much pain, & doctor/ortho surgeon said "no evidence of infection in the hardware". I had to do Vancomycin & Zosin IV for 6 weeks after surgery & PT, & after 2nd surgery, infectious disease doctor had me take oral Bactrim 1600 mg daily for a year.
Yet, just as my year of oral antibiotics came to an end, in September of 2017 my knee was red & swollen yet again...I also have Crohn's Disease, & take Entocort orally for that.
My surgeon drew some of the pus-like fluid from my knee to culture it, & nothing grew on the culture. He said it was because I'd been on Bactrim for a year. So my ortho had to take me to surgery a 3rd time to debride my knee. This time he put antibiotic beads in there. When I woke up in recovery I was in agony. I was sure he had taken out the implant because of the amount of pain I had, but he hadn't. The anesthesiologist had to do a nerve block in recovery for me to have some relief because the morphine wasn't helping at all...it was horrible.
My ortho said there was no biofilm on the implant so it was not infected, so didn't need to be removed, but if my knee developed another abscess, he would have to go in & remove the implant, put in spacers for 6 weeks, & then do another TKR. I had 6 weeks of Vancomycin IV afterward & PT.(Medicare is my insurance at this point & wouldn't pay for Zosin, too; for the previous surgeries I had private insurance).
About 6 weeks ago after I did an hour on my compression pants lymphedema pump machine, I noticed yellowish fluid running down my leg. So I pressed a little on my knee, & a whole bunch of it started pouring out. It didn't look like pus, it's a watery consistency, & I'm taking 1600 mg of oral Bactrim daily again, per infectious disease doctor. It drained for about a day from a tiny opening at the bottom of the incision from my September surgery, & then started draining again yesterday.
I don't know how my ortho can tell if these abscesses are being caused by the lymphedema in my legs or by infected hardware?
I just had 16 decayed teeth extracted 2 weeks ago; my ortho & infectious disease doc said the decay could have caused the knee abscesses & to have the decayed teeth removed asap, & Dec 4 was as soon as I could afford it.
I DO NOT want to have this implant removed & another placed if this is from the lymphedema!! It will just keep happening if that's what's causing it, right? I'm emotionally drained from all this going on for 4 years, & it seems there may be no end...
I'm seeing an ortho who specializes in implant complications within the next few weeks for a 2nd opinion, but since my knee is draining again, wondering if I just need to go to my regular ortho... I know he will say implant has to come out...
Has anyone else gone through this or anything similar?
I feel like I'm going to have a breakdown over all this! I'm disabled & live alone & have some support from my sister, but not much.
I would really appreciate any advice or comments you can offer; I appreciate your input & I know this was a long post; sorry.