Knee Infection* Alternatives to spacer & antibiotics<

[Madbkseller]

I feel like such a baby. I am just trying to get on with my life. MY OS is a revision "Specialist". Yeah, right. He doesn't even have a good bedside manner. LOL.

So just over two months ago I stood up from the toilet and it was like someone took a knife and stuck it in my left knee. It has been 18 months now since my revision. I could hardly walk after the stabbing in my knee. It became very swollen. I was leaving for a mini-vacation and really didn't want to take the time to have to go to my OS. I called anyway but he was out of the country so made an appointment with his PA. The nurse suggested that I elevate, ice and take Aleve. So, that is what I started doing. In just a couple of days it had improved so I called and cancelled the appointment.

The entire weekend we were gone I could hardly walk. There was so much pain and swelling I could hardly bear it. When I returned home I began icing, elevating and continued to take Aleve. It has improved somewhat, but now I have noticed that my left foot remains constantly swollen. Not really bad, but swollen, none the less.

I think that part of the reason that I don't want to go to my OS again is that I am afraid that he will find something serious that is wrong and I would have to go through a surgery again. I just CAN'T do that!! I am 65 years old and overweight. I have grandchildren that I want to play with but am so limited in what I can do. I am depressed. All I want to do is sleep. That way I can forget all about my aches and pains and lack of living a normal life.

I don't know what to do. I don't know if I should try some type of therapy? Water... regular or acupuncture. ANYTHING that might help. I first had trouble with my left knee 20 years ago. It began with a torn lateral meniscus. I put up with it as long as I could. Then 3 years ago I had my first TKR. 18 months later the revision. I am so sick of having no life. If I exercise a little all it does is swell and become more painful. Then I am in my chair with ice and elevation. I can't do stairs because it hurts and then swells too. HELP ME!!! I am literally at my wits end.

 

[Pumpkin]

Madbkseller,
No wonder you are at wits end, you have been through a lot and now this.
You need to get your knee checked out, it could be something unrelated to your knee, until you know you won't know what to do that will help.
Sounds like you do not care for your OS. Suggest you find someone else to take a look at your knee, who specializes in revisions and has no relationship with your present OS, not even golf buddies.
I am going to tag @Josephine our forum nurse for you.
Until then Rest, Ice, Elevate, and Medicate on schedule as prescribed.

 

[skigirl]

A pain in your buttocks might indicate a possible back problem. My friend who is dealing with this, has tried PT. For your current problem. call your OS and ask for a referral to PT. The PT can look at your knee---possibly you pulled a ligament or tendon. It is not necessarily something serious. The PT can address how to rehab the sprain, if there is one!! Sorry, but we really don't know what the problem is without seeing you and the knee. If you don't want to go to your OS, then you can try a PT first and see if it is something you can work on with exercise, ice and rest.

 

[Josephine]

MY OS is a revision "Specialist". Yeah, right. He doesn't even have a good bedside manner.

Being a good surgeon and having a great bedside manner don't inevitably go hand in hand! I've know some real bullies who were superb surgeons. Sometimes you have to take the bad to get the good.

So just over two months ago I stood up from the toilet...and it was like someone took a knife and stuck it in my left knee.

Ouch! That hurt just to read it!

I think that part of the reason that I don't want to go to my OS again is that I am afraid that he will find something serious that is wrong and I would have to go through a surgery again. I just CAN'T do that!!

Please read what you said here - read it several times and see the illogicality of it.

If I exercise a little all it does is swell and become more painful.

Then until you do find out what it wrong, don't exercise!! Just stick with the mantra - rest, elevate, ice and take pain meds. Though I would suggest Tylenol rather than Aleve, 1,000mg 4 times a day.

I don't know if I should try some type of therapy? Water... regular or acupuncture. ANYTHING that might help.

And this is the most illogical comment of all - how can anyone possibly suggest a therapy without knowing what is wrong? That's denial in it's most extreme form and I know you are more sensible than that!

So some questions:
1. can you tell me the exact site of your pain using this chart?

2. I'd like to ask you some questions if you don't mind, and it would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are ....

1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine)

2. what pain medications are you using, how much are you taking (in mg please) and how often?

3. how swollen is your leg compared to these?

4. What is your ROM - that's flexion (bend) and extension (straightness)

5. are you icing your knee at all? If so, how often and for how long?

6. are you elevating your leg. If so how often and for how long?

7. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

8. what kind of PT exercises and exercises at home are you doing? How much and how often?
This is the most crucial question so please help me by using the format I have left as an example
(which means please make a list and not an essay!) If none, just say 'none'!

Exercises:
- how many times a day
- enter exercise then enter number of reps and sets
etc., etc.

 

[Madbkseller]

Ouch! That hurt just to read it!

LF4 - D. But, if I have been on my knees for too long LF3 & LF4 - D.

Sitting here and not moving it is only about a 1. After I have been doing my usual cleaning, etc. it can get up to a 4. Additionally, I usually get extreme back pain, about an 8 even before my knee starts hurting.

Tylenol 500 mg 2 pills morning and evening.
Naproxen 220 mg once or twice a day I take 3.

Moderate Swelling, Sometimes almost huge


I know I can straighten it all the way but I don't know how to measure the flexion.

Icing very rarely unless it is swollen. Then 2-3 times a day. 15-20 minutes

I almost never elevate

Regularly I load the dishwasher, do laundry, clean and vacuum. I do some shopping, but I don't last much more than 30-40 minutes. Then when I get home my knee is killing me and at least moderate swelling.

Every time I try to do any type of exercise my knee swells and is very painful. 4-5. Then I can't get anything done around the house.

 

[Josephine]

LF4 - D. But, if I have been on my knees for too long LF3 & LF4 - D.

Similar to this?

Sitting here and not moving it is only about a 1. After I have been doing my usual cleaning, etc. it can get up to a 4. Additionally, I usually get extreme back pain, about an 8 even before my knee starts hurting.

I see

Tylenol 500 mg 2 pills morning and evening.
Naproxen 220 mg once or twice a day I take 3.

Something you need to bear in mind is that Tylenol only stays in the system for about 4-5 hours. So if you take a dose in the morning, say 8am, by midday it's worn off and you then go from midday to evening with no medication cover at all. Naproxen is not a pain killer as such, it's an anti-inflammatory so while it might help a little you really need to depend on the Tylenol more which means taking it every 6hrs regularly.

Moderate Swelling, Sometimes almost huge

I'm not surprised!

I know I can straighten it all the way but I don't know how to measure the flexion.

If you can get someone to take a photo of your knee flexed as much as you can, including the ankle and the hip (if you can wear shorts, so much the better!) I can measure it for you. Here are two ways you can do that

Icing very rarely unless it is swollen. Then 2-3 times a day. 15-20 minutes

You accomplish little or nothing in 20 minutes. Ice for at least 40-60mins and more than 4 times a day.

I almost never elevate

Why not? You say your leg is 'huge' and your pain is pretty hard. I think you need to elevate

Regularly I load the dishwasher, do laundry, clean and vacuum. I do some shopping, but I don't last much more than 30-40 minutes. Then when I get home my knee is killing me and at least moderate swelling.

You need to reduce your activity, especially the trips to the shop. They are not helping you.

Every time I try to do any type of exercise my knee swells and is very painful. 4-5. Then I can't get anything done around the house.

Don't even try then! But do post me those piccies.

 

[Madbkseller]

Josephine: Good morning. So, I have been trying to follow your suggestions. I have stopped all exercises and have been taking Tylenol as you told me to do. I haven't been as diligent about the elevating and icing, but my knee has not swollen since I started doing that.

Now, Saturday, I was at my grandson's birthday party and did just a little to help. Collecting tissue papers so they didn't blow away and handing him his presents to open. It was a really nice day and I felt a little bit more like my old self. BUT, when I got home muscles around my knee and my lower back are very sore. Sunday it was worse and today even more painful. There is no swelling....just sore. I am overweight and need drastically to lose weight. How can I do that if I can't even do the simplest of movements? Please help me. I just can't stand it anymore.

 

[Josephine]

And I've finally noticed that your revision was some 7 months ago. That's a long time to be struggling with this.
Let me see if I can think of any other options you might try.

Have you ever thought of seeing a chiropractor?
Have you considered getting a second opinion from another knee surgeon?

 

[newlybionic]

I had my revision in March too. I can tell you that on days I work my knee gets painful and swells. I've also have developed problems with my back actually hurting more than my knee. I saw my primary care doctor who prescribed a muscle relaxer for a short time and suggested a chiropractor who has been helping me. I also us an electric heating pad when my back is bad. I hope you start to feel better soon.

 

[Madbkseller]

Josephine: No, second surgery was done in March of 2015. I do see a chiropractor and have for years. I had a horse I was riding double back with a friend throw me because the friend didn't know what he was doing and then the horse stepped on my lower back. The back pain usually comes and goes. Now, if I am on my feet more than 10 minutes it acts up. I really can't afford to see a chiropractor every day. I truly appreciate any help or suggestions I might get. I am going tomorrow to see a trusted doctor who is a Rheumatologist. I have been seeing him for many years, I did a clinical trial for my knee initially and then I have seen him for shots in my knee. I am hoping that he might have a suggestion. He is the one who sent me to my current OS for Revision Replacement. Thanks again for all the help.

 

[Madbkseller]

On top of everything else I had really bad Vertigo yesterday and couldn't drive to the doctor. I had to cancel. I do want to know your opinion. Dr. Trapp is a Rheumatologist I have know for many years and used for shots in my knee. He is the one who suggested that I go see a specialist for my revision. Should I go to him and see what he thinks about my current problems with my knee or should I just go back to my OS that did the revision? I guess I am just bothered by the fact that most of the problems I have with my knee he gives to his PA. I guess they just don't understand the trouble I am still having and my desire to lose weight. Hard to do when you can't really exercise. SO?????

 

[newlybionic]

I think at this point you might want to find another OS with fresh eyes to look at your knee. It's been quite some time since your revision. Maybe you can call Rheumatologist for a name.

 

[sheliac]

I agree with Marian. A new set of eyes seems to be in order.


Shelia
RTKR - 8/23/16
LTKR - 10/11/16

 

[Josephine]

So do I. 100%

Dr. Trapp is a Rheumatologist I have know for many years and used for shots in my knee

No disrespect to your doctor but I've always considered rheumatologists to be a waste of space. I've known them pass up on a dear lady of 60 with very bad arthritic hips, telling her there was absolutely nothing could be done for her. Since I happened to be working at the local hospital, I got her seen by our hip surgeon who got her in for one hip then decided to do both of them. Having been housebound in her third floor flat for 3 years, she was delighted to be able to return to her afternoon tea dances within about 6 months! There are others of similar ilk but you get my drift.

 

[kneeper]

So do I. 100%

No disrespect to your doctor but I've always considered rheumatologists to be a waste of space. I've known them pass up on a dear lady of 60 with very bad arthritic hips, telling her there was absolutely nothing could be done for her. Since I happened to be working at the local hospital, I got her seen by our hip surgeon who got her in for one hip then decided to do both of them. Having been housebound in her third floor flat for 3 years, she was delighted to be able to return to her afternoon tea dances within about 6 months! There are others of similar ilk but you get my drift.

I would agree that rheumatologists are the people to see about the question of orthopedic surgery for OA. But they are very good on things like RA. That's where their training lies.

 

[Madbkseller]

Jo, first of all, I would like my posting title to be changed to, Spacer for revision and right knee popping out. Unless you can think of a better title for my new problems. So, three weeks ago I went to my OS's PA. Marty... They took x-rays again. He said that the appliance looks fine, but there is a little movement, loseness in my knee. He suggested that I wait 3-6 months and then make an appointment with my OS. He said that he may choose to put in a "spacer". I came home and did my usual research online about what a spacer is, the surgery involved, etc. Very disappointing. The LAST thing I want to do is have another surgery on my left knee. UGH!!! It has now been just over four years since my first surgery. I have more pain in my knee now then I did before my initial surgery. I have been very depressed as I have said before. I just want to cut my leg off. I have always been very active and did not ever imagine that at the age of 65 I would be almost cripple. So, two days ago, as I stepped out of bed I heard and felt a very loud pop. I almost fell, losing my balance. Now, since then, it kind of comes and goes. I can be walking, well kind of like walking, and it feels like my knee is just going to collapse. I am so afraid of falling, I am scared to walk. My husband even brought in the walker I used after my other surgeries. I hate to even see it. I have an appointment with Marty, the PA on this Thursday, 12/15 and then the soonest I could see my OS is 1/25. GEEZ!!! I can't even walk.
What I need to know is should I get a different OS? My cousin is an OS, but it is about a 10 mile further trip. Not a problem, but... just saying. Also, until I get in to see someone who can DO something, is there a brace that I could use that would give me a little support? I bought one of the Copperfit braces, but it is way to tight above my knee. It just squeezes and it hurts. I want one that doesn't slip down or squeeze too tight.
I am just lost. I am a Christian and Christmas is my favorite time of year. I love doing my decorating, baking, cooking and presents along with spending time with my grandchildren while they are out of school and here at my house. I just feel so alone like no one can truly understand the pain and frustration that I feel all day, every day.
My husband thinks I should contact a lawyer and sue for pain and suffering. I am sure that you know if that is even a possibility. I don't think that there is much I can do in that direction.
Please help me. :( I am literally at my wits end.
I gladly welcome comments from anyone who can help.
Thanks in advance and a Very Merry Christmas to you All.

 

[FlaGranny]

So sorry you are having problems after all this time. The only suggestion I have for you is to make an appointment with a new surgeon, a revision specialist. At this point you having nothing to lose.

About your husband's suggestion for suing, you would get nowhere without that second opinion, and maybe even a third.

Perhaps you could stabilize your knee a bit with an Ace wrap. Get the widest wrap you can find . That might help a little.

Don't fear another surgery if that is what you really need. You need your life back.

 

[skigirl]

I am sure you are feeling desperate--you have been through a lot. I am also a grandma and know how you want to play with them. Why not do this, call your cousin and ask him to look at your knee. When you are there, ask him to recommend a revisionist to look at your knee as well.

Even though you are in pain, there is no quick fix. So, take your time and do the research. Most of all, I would not let the surgeon who did your knee touch it until you have found out the problem from someone else. It is frustrating, but necessary.

I think a brace is a good idea, right now you need a brace to make your life easier. I used a don joy unloader brace before my surgery and it did help me quite a lot. I know your leg might be a little bigger, but I am sure they make braces for bigger legs too. Is there a medical supply place near you? They often have a selection. And, you can shop in your own home too.

Most of all, i think you are going to have to wrap your leg or get a brace so that you can enjoy the holiday. I think your cousin might be able to help with the brace for you---see if he will give you a 'family appt" right away.

 

[newlybionic]

I agree that I wouldn't go back to the original OS. He and his office haven't been very helpful to you. Call your cousin and go see him. Ask him to help you get an appointment with an OS who specializes in revisions. Sometimes if one doctor calls another they can help to arrange a quicker appointment. I used an unloaded brace too before my surgery. I know that here in the US it was over $500 that my insurance fortunately paid. Your cousin might back eine able to come up with a backeenerace that would be helpful for a much lower price. His office may even carry something there.

 

[Madbkseller]

Thanks for the advice. I just found out that my cousin is a revision specialist. Go figure. When I saw him years ago he wasn't or I would have gone to him for my revision in the first place. I think I will call him today and get an appointment as soon as possible. My right knee hasn't "popped out" for a day because I am walking very carefully. Funny I am using my revised knee as the stronger one to give support to the other knee now. Life is so crazy. I have days that I just think I can't go on anymore and then other days that I think, "Hey, I can get through this." I was talking to a friend of mine about my problems and what does she tell me??? She has a friend that is on her 7th surgery and is still having problems. THANKS. Just what I wanted to hear. OK...so I am going to get some kind of temporary support until I can see my cousin and get an appointment with him as soon as I get done typing. Thanks so much ladies. I don't know what I would do without Bonesmart.