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Revision TKR 2nd revision oct 1 recovery

You should be able to look up the orthopedic surgeons at the Mayo Clinic, their information should have if they specialize in revisions or complex joint reconstruction.
I agree, doing a Zoom visit with HSS is a great place to start looking for answers.

@PegGar16 was treated at the Mayo Clinic in Phoenix and has good results after multiple surgeries.
 
Dr. Maale in Dallas is good.

I have these recommendations at the Mayo Clinic in Rochester:


Rochester, Minnesota

Mayo Clinic
Dr. Matthew P. Abdel (also works with infections)

Faculty at 2018 International Congress for Joint Reconstruction (ICJR) meeting on problem case diagnosis - hips and knees

Dr. Tad Mabry - main presenter
Dr. Kevin L. Perry
Dr. Michael J. Taunton
Dr. David G. Lewallen

I would also suggest seeing Dr. Della Valle at the Hospital for Special Surgery in New York. There is a special orthopedic group there that deals with problem cases and you can start the process long distance.

New York

New York City
Hospital for Special Surgery (HSS)

Stavros Niarchos Foundation Complex Joint Reconstruction Center is a special program created with a $10M grant that deals with diagnosing and treating the most challenging knee and hip replacement problems. As part of the diagnosis, a committee of surgeons meets to discuss your case. There is a $500 fee for your case review. This center is headed up by Dr.Thomas Sculco.

Edwin P. Su - Primary TKRs, works with hand held navigation for better implant placement and balancing of knee ligaments.

Hospital for Special Surgery
535 East 70th Street
New York, NY 10021
212-606-1000
https://www.hss.edu/physicians_su-edwin.asp

Dr. Bostrom
Speaker at 2018 ICJR workshop on problem hips and knees
Dr DeFelice
Dr. Della Valle (I have heard several recommendations on this surgeon)
Dr. Jerebek
Dr. Westrich

Please try to get some additional opinions if you can before accepting fusion or amputation. Those are absolutely last resort treatments and I don't think you're at that point right now.
 
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Hi! I just read your thread. Do you have an Infectious Disease Doctor?? A high CRP doesn't always mean infection, it shows inflammation. When you mentioned not being able to lift your leg and extend it I thought of the patella tendon. That is how they knew I had ruptured my patella tendon before getting X-rays. Sitting on the gurney with my legs hang over the side I could not lift the lower half of the leg to straighten it out. I was sent to a doctor at the Mayo Clinic in Phoenix because of the complexity...I never do things they easy way :) The infection had turned my tendons to mush and the knee prosthetic had already been removed. They made sure the infection was gone, put in the new knee and reconstructed the extensor mechanism with an allograft. I have no issues with this leg at all. Please get a specialist. I would get your medical records and send them to all four places to see if someone would take your case. See if they take your insurance, and get referrals if needed. Be very proactive with your insurance and physician offices.

I have to say this...The "perfect world" comment really upset me. Next time tell him that in your world you expect perfection (or as close too) from professionals....ugh
 
MAYO in Jacksonville FL----Please read her info on the Mayo page. My surgeon also specialized in Oncology....She reconstructs failed knee joint replacements.
Courtney E. Sherman, M.D.
  1. Orthopedic Surgeon

search for a doctor
[Bonesmart.org] 2nd revision oct 1 recovery

Departments
  1. Surgery
  2. Orthopedic Surgery
Specialty Groups
  1. broken link removed: https://www.mayoclinic.org/departments-centers/orthopedic-surgery/orthopedic-oncology-minnesota
 
She sounds like an excellent resource for this type of problem. I think you should put her at the top of your list for consideration since you now have a personal recommendation. Good luck and let us know how things go.
 
I cannot thank you all enough.
You all are amazing. I have an infectious disease physician and rheumatologist but
I’ve had a difficult twist of fate. My other knee replacement placed in may 2018 and revised with larger liner in dec 2018 is infected. It had been more stiff in the last 2 months but I woke up last week with a bunch of swelling and new pain.

He aspirated it Friday and an X-ray showed lytic areas in the tibia concerning for infection and or loosening. He called Sunday morning. It’s infected based on labs he drew, joint fluid, X-ray changes. I went through all this on the right knee in 2016. I’ve been on chronic doxycycline through my infectious disease physician for years. They will be doing a 2 stage Surg to take out the implant etc. IV antibiotics at home for 2-3 months then Reimplantation. he feels it a chronic infection due to the lytic areas on X-ray that has now manifested itself. My husband and I are trying to just keep our heads up.
 
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I’m so sorry you have another infection. :console2: Please keep us posted.
 
So are you staying with your previous surgeon then? I'm so sorry to hear an infection has been confirmed, but it sounds like quick action will be taken and that's good. Please let us know how you're getting along. If you do decide to get some additional opinions from surgeons, I'd definitely like to know who you see and how things go with them. We really depend on our members to tell us where the specialists are out there who can get the job done and have good bedside manners.
 
Hi everyone. I had surgery feb 23 with my previous surgeon to take out my replacement in my left other knee due to infection. I was in the hospital for several nights due to cultures resturning. I ended up Growing 2 different gram neg bacteria. I am on 3 different antibiotics for 6 weeks then hopefully I will get a née knee. I have a weight bearing spacer now. The post op pain has been awful. My other knee was infected in 2016 but I didn’t have quite this much pain.
 
@PinckneyJ So sorry you are dealing with another infection! Have you asked for alternate medication. Each and every recovery is different so you might need different medication to address this pain.
 
Hello PinckleyJ. I was reading Victor Frankl and came across this early on from the forward by Harold Kushner.
''I have known people who rose to the challenge of enduring the most terrible afflictions and situations as long as they believed there was a point to their suffering. Whether it was a family milestone they wanted to live long enough to share or the prospect of doctors finding a cure by studying their illness, having a Why to live enabled them to bear the How.''
 
Thank you all so much for all of the support. I finish my antibiotics this week (7 weeks). They will let my knee sit for 2 weeks then aspirate it. If clear I will get a new knee replacement. I can put weight on my antibiotic loaded spacer. It’s been in since feb 24 2021. It has become so painful. Xrays are neg. I see my surgeon tues. I have been searching for others with these spacers and what made them more comfortable. I almost went to ER last night due to pain.
 
On the Knee Recovery page if you click on the
[Bonesmart.org] 2nd revision oct 1 recovery
title, you will be taken to everyone who has or has have a knee infection. You should find many answers to your questions.
 
I am set to have my knee spacer taken out and a new knee put in may 25. I grew klebsiella in this knee. It’s been a real struggle with pain but im hoping for better days ahead!
 
I'm glad to hear things have improved for you! Can you tell me, did your doctors give you the Phage Therapy treatment? Your particular "bug" is one that's not been common here on BoneSmart and I'd like to know some details about how it was treated and how the doctors have arrived at the decision to go ahead with your revision. This information will be helpful for others who might experience what you've been through.

The information may be in your past posts, but it would be every so helpful if you could put a short compilation of what has transpired in a single post.
 
Hi Jamie so I actually grew 2 bacteria in this left knee. I see infectious disease and live in NC. My surgery was at a big teaching hospital that is well respected. My surgeon is just exceptional. I grew this time Klebsiella and Pantoea agglomerans. My other right knee infection in other replacement was culture neg. in 2016. I was on Cipro. Doxycycline and oral vanc for 2 years. Then I’ve been on doxy twice daily since 2018.
I have rheumatoid. No diabetes. But I’ve had multiple surgeries. I’ve worked in medicine as a medical provider a long time in the ICU but but not since 2019 due to knees. This time this left knee was put in by a different but excellent surgeon in 2018. Revised with a larger liner in 2018 also. I had been focused on other knee but had worsening stiffness for months in this left knee. Woke up one morning With sharp pain. X-ray showed chronic infection. Tibia had osteolysis under implant. Crp and esr were elevated. Synovial fluid had 1700 wbc and 81% neutrophils. My surgeon called super bowl Sunday with the news he thought it was infected. Incision had never looked bad.
My klebsiella and panteo were sensitive to oral Cipro which I took 6 weeks. I think the klebsiella was in the tissue. I have been able to put weight on my spacer. They have followed Crp esr and d dimer which is now normal. Synovial fluid looks good. Plan is reimplantation may 25. It had been a hard road no doubt. Lot of swelling with the spacer and I’ve been in a hinged brace.
I say all this to maybe prevent someone else from going through this. If you get stiff in your replacement let your MD know.
 
Thanks for the synopsis of your situation. It helps me a lot. You've been through so much, but I'm glad to hear things are moving in a positive direction now. Your post will help others as well.

I know you are worried. Anyone would be with all the challenges you've faced. But yours was a double whammy of an infection and that can make things take longer. Small steps is the best way forward and it sounds like your medical team is on top of things. Please keep us updated and don't hesitate to talk about anything that's worrying you.
 
Hi Jamie. Thanks so much. I have made it my mission to make physical therapists, patients etc aware of these late infections. That swelling and stiffness aren’t normal after a certain time period. And it’s usually somewhat easy to see some kind of Ortho provider in the US. Not sure about the UK. Even if you think it’s nothing get it checked!
 
I had my total knee revision may 25 and was discharged may 28. Spacer was removed. Pain control was an issue. Cultures are so far negative. I’ve had persistent numbness in my leg and lack of motor function in my leg. I had an adductor canal block. It’s nice to be home. I came home with a wound vac to be removed June 1. I’m on a walker with an immobilizer while up to prevent a fall since my part of my leg is still numb. This is a journey to say the least!
 
I hope all goes well from here on.

Just as a reminder, I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Just keep in mind all people are different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

Knee Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
2. Control discomfort:
rest​
ice​
take your pain meds by prescription schedule (not when pain starts!)​

3. Do what you want to do BUT
​
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you​
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​


4. PT or exercise can be useful BUT take note of these
​

5. At week 4 and after you should follow this

6. Access to these pages on the website
​

The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling
Heel slides and how to do them properly
Chart representation of TKR recovery
Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in the majority of BoneSmart’s forums, we ask that each member have only One Recovery Thread. This policy makes it easier to go back and review the member’s history before providing advice, so please post any updates or questions you have right here in this thread.
 
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