Knee Infection* Cakes 2114 - Knee Recovery Thread

[Cakes2114]

Hi all!
I found out yesterday I have a MRSA-staph infection in my nose.
Results came back from my pre-op appts from this past Monday.
I am on a gel ointment until surgery.
Anyone have experience with this? Any future issues

Results from the other swabs have not been indicated as of now.

Also I am Vitamin D deficient so I am on 4000 mg until surgery‍

 

[Pumpkin]

Hi Cakes,
We have a few members who have had MRSA in their nasal passages. The treatment is gel ointment until surgery. It is not uncommon to be a MRSA carrier, the gel should get rid of the MRSA.

Be glad your OS is diligent in testing you and following up with the appropriate treatment.
I have not heard of any problems with this.

 

[Cakes2114]

Does anyone know an estimated amount of time for the first stage of a knee revision? I know they probably vary but I was wondering the general amount of time.

 

[Celle]

Does anyone know an estimated amount of time for the first stage of a knee revision?

I'm not quite sure what you mean.
Do you mean how long does the surgery take?
Or how long after the knee replacement hardware is removed and you have an antibiotic spacer before the hardware can be re-inserted?
Or how long does it take to recover from the actual surgery?

If you mean how long will you be without the replacement hardware, and with an antibiotic spacer in place, that depends on how your knee responds to the treatment.

The course of IV antibiotics through the PICC line is usually about 6 weeks. Then you'd have to have more blood tests and an aspiration of your knee fluid, to see if the infection is gone. It is best to have an Infectious Disease doctor on your team, to interpret the results and suggest further treatment, if necessary.

They won't re-inset replacement hardware until they are sure that all signs of infection have gone. That's why it's hard to predict how long all these stages of treatment will take.

 

[Cakes2114]

Does anyone know an estimated amount of time for the first stage of a knee revision?

I'm not quite sure what you mean.
Do you mean how long does the surgery take?
Or how long after the knee replacement hardware is removed and you have an antibiotic spacer before the hardware can be re-inserted?
Or how long does it take to recover from the actual surgery?

If you mean how long will you be without the replacement hardware, and with an antibiotic spacer in place, that depends on how your knee responds to the treatment.

The course of IV antibiotics through the PICC line is usually about 6 weeks. Then you'd have to have more blood tests and an aspiration of your knee fluid, to see if the infection is gone. It is best to have an Infectious Disease doctor on your team, to interpret the results and suggest further treatment, if necessary.

They won't re-inset replacement hardware until they are sure that all signs of infection have gone. That's why it's hard to predict how long all these stages of treatment will take.

I was wondering how long is the actual procedure. I go in on Monday and was trying to give my husband an estimate of the time since no visitors...

 

[Celle]

There's no way of predicting how long the actual surgery will take, but it's probably somewhere between 45 and 90 minutes.

Add on top of that the time you'll spend in pre-surgery, and afterwards in the the recovery area before going to your room, and tell your husband he probably won't hear anything much before a couple of hours after you go to theatre.

 

[Cakes2114]

Well folks so the surgery was successful. They put in a partial articulating antibiotic spacer which does allow for some partial movement.
I had surgery on Monday and still waiting on the culture from the bacteria that was found during the stage 1 revision and at the hospital.

I also have a drain and a negative pressure wound therapy machine right now. A PICC was put in two days ago and has been used since that time so I am IV free.

PT has gone great and I am partial weight bearing. I went pretty far today and got approval for my brace to be unlocked to 45 degrees for heel slides.

Hopefully, the culture provides more information tomorrow or I may go home with a broad spectrum antibiotic.The ID doctor was actually shocked I had an infection that was identified immediately but it seems to have been contained in a specific section of my knee. The OS during the surgery stated he knew he was right and there was an infection since my blood work was not showing a massive infection - I was merely lucky and it was contained. Now they need to try to figure out what the bacteria was so they can use a specific antibiotic.

I have been in a isolation room since I came out of surgery due to the MRSA in my nose which is starting to wear on me. Not much on TV besides coronavirus coverage or terrible TV.

 

[Sara61]

Glad to hear your surgery went well hopefully they will sort you out quickly and clear your infection and sort out the antibiotics for you - Yes TV world wide pretty much the same - maybe take this time to read instead - Wishing you a speedy recovery and stay safe xx

 

[Cakes2114]

Has anyone had a torn MCL found in the first stage of a total knee revision?

I am back home and going over everything from this past week and this was the one unknown. I knew the previous revision was unstable but not where the exact issue was. Dr. Bostrom plans on using a replacement that will deal with that instability.

I have my home antibiotic setup and had my first treatment today. The infusion nurse was so sweet.
Now for hopefully 4-6 weeks of antibiotics at home. 2 weeks of antibiotic free and then the last surgery
Also there were some issues with my release last night (from the Covid-19 situation and being one of the first patients since HSS was only doing emergency surgeries). Everything was settled and now I feel like I can relax and be home in a much happier situation.

 

[Cakes2114]

Stomach issues... I know I am on all types of medicine from IV antibiotics to pain meds.
Does anyone know of a good tea I could try to calm things down? Or any other suggestions?

I am taking probiotics and once my husband goes back out food shopping we will add some yogurt into my diet (most of the state is still locked down from COVID-19 so we are trying to go to the food store as little as possible).

 

[Celle]

PT has gone great and I am partial weight bearing. I went pretty far today and got approval for my brace to be unlocked to 45 degrees for heel slides.

Don't worry too much about heel slides while you have the antibiotic spacer in place. While that is there, ROM usually can't improve much. Just keep your knee moving gently, but forget about the numbers.

Has anyone had a torn MCL found in the first stage of a total knee revision?

I am back home and going over everything from this past week and this was the one unknown. I knew the previous revision was unstable but not where the exact issue was. Dr. Bostrom plans on using a replacement that will deal with that instability.

When the time comes for Stage 2 - re-insertion of your knee replacement hardware - your surgeon will use a special type of replacement hardware that is designed to keep your knee stable and take the place of your cruciate ligaments.

It's called a Cruciate Sacrificing Implant:
When the cruciates are in poor condition or even ruptured, a prosthesis is used which has a peg on the plastic insert and a notch on the femoral component to take over their functions of keeping the joint stable.

Stomach issues... I know I am on all types of medicine from IV antibiotics to pain meds.
Does anyone know of a good tea I could try to calm things down? Or any other suggestions?

It might be a good idea to ask your own doctor for some anti-nausea medication, , such as Zofran (Ondansetron).

Remember never to take your medications on an empty stomach - have a cracker or something similar, particularly with your pain medications.

 

[Cakes2114]

PT has gone great and I am partial weight bearing. I went pretty far today and got approval for my brace to be unlocked to 45 degrees for heel slides.

Don't worry too much about heel slides while you have the antibiotic spacer in place. While that is there, ROM usually can't improve much. Just keep your knee moving gently, but forget about the numbers.

Has anyone had a torn MCL found in the first stage of a total knee revision?

I am back home and going over everything from this past week and this was the one unknown. I knew the previous revision was unstable but not where the exact issue was. Dr. Bostrom plans on using a replacement that will deal with that instability.

When the time comes for Stage 2 - re-insertion of your knee replacement hardware - your surgeon will use a special type of replacement hardware that is designed to keep your knee stable and take the place of your cruciate ligaments.

It's called a Cruciate Sacrificing Implant:
When the cruciates are in poor condition or even ruptured, a prosthesis is used which has a peg on the plastic insert and a notch on the femoral component to take over their functions of keeping the joint stable.

Stomach issues... I know I am on all types of medicine from IV antibiotics to pain meds.
Does anyone know of a good tea I could try to calm things down? Or any other suggestions?

It might be a good idea to ask your own doctor for some anti-nausea medication, , such as Zofran (Ondansetron).

Remember never to take your medications on an empty stomach - have a cracker or something similar, particularly with your pain medications.

so much good information!
I am on Pantoprazole for my stomach now (and because I am also on aspirin). Will Zofran still be an option?
I have been trying to have a cracker or half a protein bar before any meds but I think there are just a lot of medicine now:

vancomyocin
Aspirin
Vitamin D
meloxicam
Oxycodone (as needed)
Acetaminophen (as needed)
Pantoprazole

I honestly have slowed down on the Oxy (2-3 times a day at a lower dose). Lots of ice and sleep have helped with the pain.

 

[Cakes2114]

It is such a mentally difficult thing to have a knee replacement.
Having a two staged revision is very difficult. You know what a long road it is to have a replacement. When you do the first stage and are waiting for the second it is honestly the longest wait ever! I am not even fully done with week two and I am starting to get antsy... potentially 4 more weeks on antibiotics and six more weeks before a final replacement is such a long wait!
So mentally difficult!

 

[sistersinhim]

Come on here and spend time with us. That will help you to whittle those days away. Someone is always here to talk with you. I found it to be very uplifting. That's why I'm still here. I know how much it helps to be able to talk to someone who understands what we are doing through.

 

[Jockette]

I’m so sorry you are dealing with an infection. @Defender is dealing with one, too.

 

[Cakes2114]

Come on here and spend time with us. That will help you to whittle those days away. Someone is always here to talk with you. I found it to be very uplifting. That's why I'm still here. I know how much it helps to be able to talk to someone who understands what we are doing through.

Thank you!

 

[Cakes2114]

Thank you all... I think the major issue I am struggling with is I have a second surgery on the horizon.
That is so much to tackle right now with the world issues and also having a knowledge of how long it takes to recover.

 

[Jaycey]

@Cakes2114 It's such a difficult time for everyone now. Big respect to you in dealing with your revision and all the other chaos! Just try and keep your mind off the time it takes to heal. You can't rush this recovery and you need to focus on staying healthy and getting rid of that infection.

We are here for you!

 

[JennyLynne]

Just catching up on your story... and it’s some story! Sounds like you are on a good path and everything is heading in the right direction.

I had surgery 4 days ago so I’ll be here if you need company! Usually these boards are so active, but clearly quieter down by all the postponed surgeries.

 

[Cakes2114]

Just catching up on your story... and it’s some story! Sounds like you are on a good path and everything is heading in the right direction.

I had surgery 4 days ago so I’ll be here if you need company! Usually these boards are so active, but clearly quieter down by all the postponed surgeries.

Thanks so much for the kind response... anyone who has any understanding with these things can help.
It is so hard to not feel isolated with these surgeries and then in top of it the coronavirus.
loge is so complicated now!