Knee Infection* Alternatives to spacer & antibiotics<

[Madbkseller]

Celle: I really haven't spoken to my ID since she released me after my PICC line was taken out. I have spoken with my OS's nurse. She said that they have had the best success with Clindamycin and he really doesn't want me to change to a different antibiotic. I have talked with my GP's nurse. She said that he was wondering why my OS was pushing this off on him. So.... she also said that I should probably have my antibiotic changed. It just scares me to death to even take the slightest chance that I would get an infection in my knee again. My daughter asked me if I was sure that it wasn't just dry skin...but I would think that one of the lotions or creams I had put on would have helped that too. ????

 

[Jockette]

 

[Madbkseller]

Josephine: so, My doctor called in a cream for me to try. It's TRIAMCINOLONE 0.1% CREAM 30GM ..so hoping that it helps. But...now...here's the story. Since the end of June, when I had my antibiotic block and two rods put in my knee, I have been sleeping in a recliner. About two weeks ago I decided that it was time to go sleep in my bed and I was really looking forward to it. I woke up in the middle of the night with a horrible backache. I stuck it out for the night, waking up about five more times...hurting. In the morning I could hardly move. It was extremely painful to move at all. So back to the recliner. Last night I decided to try it again. I took a mild muscle relaxer to see if that would help me relax and not tense up my back again. No such luck. Same as before. I woke up four to five times and finally got up out of bed at 4:30 this morning and back to my recliner. I don't really want to sleep in a recliner for the rest of my life. But it is very very painful sleeping in my bed. Please tell me that you have a couple of suggestions...or anyone else who has had this problem.

 

[sistersinhim]

Are you elevating in bed? That might help.

 

[KarriB]

Sleeping on my back in bed is terrible for my back. I had a backache everyday for months after my TKR surgery and infection until I could spend the majority of the night on my side. Even though you were in the recliner on your back it supports your back differently. Are you able to change positions in bed?

 

[Jockette]

The only way I can sleep on my back is to elevate my legs. I learned to like it so much that I still sleep with my legs up on my foam elevating wedge that the hospital sent home with me.

 

[Madbkseller]

KarriB so... Propped myself up in bed. Still just a little backache but nothing like it was. I think this might work to get me sleeping in my bed again. Thanks for the suggestion,

 

[KarriB]

I’ve been down with the flu and a fall! Ugh! I’m glad it helped to prop yourself a bit. Even with my immbolizer on I managed to sleep a few hours a night on my right side. I’d lay on my right and carefully place my left leg over my right thigh. I couldn’t stay that way all night, but it was great for a few hours. I hope it continues to help.

 

[PegGar16]

It is n'ice to be able to sleep in your own bed....or even just sleep. How are the antibiotics going?

 

[donnag1108]

I slept on my couch until this past week but had the same issue when I did try to sleep in bed. I found on a few occasions when I tried to sleep in my bed if I put 4 pillows against my headboard leaned up against them and did not lay flat I got a bit of relief from the back pain and a little sleep in bed but I'm definitely a side sleeper. I don't have back issues but that pain was so miserable on top of trying to recover so I know how you feel. I hope you can get some relief.

 

[Madbkseller]

New question and not sure if I should just be adding this here or not. Continuation of my surgical problems.

So, as it is written here, I finally had my last revision to put my knee back in after an infection. That was October 8, 2018. Everything went well and I choose to do PT myself, at home. After a couple of months, most of the pain was gone, I have full extension, probably because of weeks with rods through my knee.

I have limited flexion now. I have a recumbent bike and made good progress for quite awhile and then it just stopped. I was pretty sure that it was scar tissue. I had an appointment a month ago with my OS. He agreed that that was what it is and said that he could do arthroscopic surgery again, which worked before, and clean out all the scar tissue.

He said he really didn't want to do that because of the fear of getting an infection in my knee again. Which of course is the absolute last thing that I want or need to have happen. I have order a Therapeutic Percussion Massager with heat. I am hoping that I can loosen up the scar tissue with that and then get on my recumbent bike and stretch it out and break up the tissue so I can bend my knee again. I have started having pain again and a lot of stiffness.

Any help will be truly appreciated.

 

[Jockette]

I’ll tag @Josephine for you, to address the above post.

 

[Josephine]

I was pretty sure that it was scar tissue. I had an appointment a month ago with my OS. He agreed that that was what it is and said that he could do arthroscopic surgery again

I don't agree even with the existence of 'scar tissue'. Most problems with ROM is due to swelling and pain.

 

[Madbkseller]

Except it has been over 9 months since my last surgery. It hasn't been swollen for a long time. The pain comes mostly from overdoing my cleaning, walking, etc. So, no suggestions?

 

[Madbkseller]

Ok, so like I said I saw my OS in June as I am still having a lot of pain in my knee. My last replacement was 10 months ago. I still have very limited flexion. I am at a loss of what to do. I have started walking off and on and then something happens and I get off my schedule of walking and I stop for a few days and then try to start again. I also haven't used my recumbent bike for months. So, maybe I am answering my own question. I feel like if I went back to my doctor and asked him to do Arthroscopic surgery to clean out my knee that it really would help, but I seriously do not want to take even the remotest of possibilities that I would get another infection. I have really been depressed and frustrated the last week. It's just becoming overwhelming. Any suggestions are welcome.

 

[Jockette]

The pain comes mostly from overdoing my cleaning, walking, etc.

I wish we had a solution for you. You’ve had a lot of things done to your knee the last several years and it may just take a lot longer this time to recover.

 

[Jamie]

I can understand you being hesitant to have another "cleanout" surgery. They are sometimes successful and sometimes not, so risking an infection might not be worth it for you.

I do think you've answered your own question, though. Some knees are just a lot tougher to recover than others, especially if there are some adhesions involved. It's not a common problem, but it can occur.

The key point I noted from your description of your pain is that it occurs when you overdo things. It's not a constant pain. That would indicate to me that you're still in the recovery phase and it's not an issue with scar tissue. You can have swelling in your knee that impacts pain and movement that you won't see. The knee compartment is very compact and it doesn't take much fluid from irritation there to cause a problem. You know, recovery can continue in some knees for well over a year. It's truly an individual thing.

I know "life" can sometimes get in the way of sticking to an exercise schedule. But it does sound like you might benefit from a slow and steady program of walking and/or using your exercise bike to gradually increase strength and flexibility in your knee. Perhaps you could get your GP to approve a month or so of physical therapy for you to get that going again. Since your pain is not constant, this seems worth it to try before considering any additional procedures on your knee. A good therapist can help you develop a program that will work for you even after the sessions have stopped.