TKR Cococay in pre-op

[Spacedust]

Came across just fine to me, I think. Here's what I think you're asking:
1) Is there a generally higher risk of infection because of having a knee infection, or
2) Is the concern that any potential infection will get to the baby bionic knee and wreak havoc?

I would add:
3) Are both 1) and 2) true?

 

[DEL2021Feb-17]

There is always a risk of infection whether its from a simple cut or in this case a TKR. Just because there is a risk does not mean the odds are high and while infections do happen its not something I would worry about. There are times a surgery will get postponed if you have an open wound but other than that your good. As it happened to me I had an infection 2 weeks after my 4th TKR. The knee was red more swelling then usual high fever ( it peaked around 102?? ) trust me its no fun. In my case I have a higher chance of getting another infection then someone who has never had one and yes it bugs me. After surgery you will be told what to look out for and what to do just in case. If I remember correctly when I had in-home PT and in- home health care ( you will be put on blood thinners ) the nurse would always check and remind me what to look for.
Does this help?

 

[DJL1967]

I have 2 questions that have come up from reading others threads-
** regarding the ACL and PCL during TKR- someone asked about if they are saved during surgery and a link to a whole article with tons of info was given so I read it - —so out of curiosity- would a person usually know if it’s likely the ACL-PCL are bad or is it fairly common that the degeneration of the knee impacts them?

Well I've had bilateral ACL repairs done in 1988 (R) and 1990 (L) and on my MRI it shows severe degeneration of the ACL and PCL 32 yrs later. Not sure if this is a normal aging process or if I did damage from my extreme skiing days.

 

[Al Zymers]

I have had the very same questions concerning infections. I have wondered if the new knee would become a "magnet" for infections after a joint replacement.

A lady I work with has had both knees replaced - the last one about a year ago. She says she gets cuts and scrapes working in her garden and occasionally gets scratched by a pet, but says she doesn't worry about it. I am not even sure if she puts any antibacterial ointment on those cuts.

On the other hand, some specialists in prosthetic joint infections recommend very strict control over any skin condition both before and after a replacement for the rest of your life. They even go as far as recommending men to have their prostate operated on before the replacement to avoid any chance of a urinary tract infection afterwards. If every UTI could cause an infection in the replaced joint, that would be very worrying indeed.

 

[Cococay]

Thank you for the replies- it does help. It’s a scary thing- to me , maybe because of the forever factor?.

 

[newlybionic]

I’ve had infections in other parts of my body but none of them has caused an infection in my bionic knees. I had an infection in my knee from the surgery. It was dealt with very aggressively. I have no risk of getting an infection in my knee than anyone else.

 

[Cococay]

I scheduled my preop for next Wednesday-the 25th-just about 3 weeks before surgery- and my OS surgery coordinator already scheduled PT for when I’m home and my first post-op.

I only now have left to schedule covid test but I’m telling you- I will not do the dreaded nasal swab..

However-they just put restrictions where I live- just yesterday —all indoor gatherings- sports -gyms-restaurants etc etc - they have not yet said electives are cancelled but I had a video appt with my dr for something totally unrelated to this or my OS and he told me that the hospital he is affiliated with- major metro county hospital will be canceling and the plan is likely he said to be only surgery that someone needs to live because our hospitals are so full they need to use operating rooms to convert to critical care units-!

Again / nothing’s announced and the hospital I’m going to hasn’t said anything-but it’s hard to wonder what will happen- all the prep knowing it very possibly could get cancelled literally right before. So I’ve been asking myself -do I cancel now and schedule a date farther out to avoid the Chance it gets pushed a lot farther?

I am so limited physically which has impacted my mental health to a depression I can’t get out of. Friday after work- every week - I come home and I sleep and do nothing all weekend- .actually except for work I do that every day—— It’s crazy it took sooo long for me to accept I needed surgery and agree to it and schedule it- to now being so worried it will be cancelled....Sorry to whine. I know we are supposed to keep it positive on here.

 

[Jaycey]

@Cococay I would wait and see how the situation in your hospital develops. You have bit of time.

You need to keep your eye on the prize here. Your mobility is now limited. The longer you limp around, the more impact this will have on your body. Pre-op procedures, although nerve wracking, are necessary to make sure you are safe. Staff will help you through this process.

Cancelling the op yourself may mean you are put to the end of a very long list. If you let the hospital reschedule your wait may be shorter. But as I say - there may not be any change. We can't predict.

 

[Celle]

On the other hand, some specialists in prosthetic joint infections recommend very strict control over any skin condition both before and after a replacement for the rest of your life. They even go as far as recommending men to have their prostate operated on before the replacement to avoid any chance of a urinary tract infection afterwards. If every UTI could cause an infection in the replaced joint, that would be very worrying indeed.

Some surgeons are more risk adverse than others, but there really is no need to live your life in fear of getting an infection in a replaced joint.

While an enlarged prostate can cause retention of urine and not emptying the bladder completely can occasionally be a contributing factor in getting a UTI, I suspect the advice AL Zymer relates is only given to a limited number of men.

There's no point in having the prostate removed unless it is severely enlarged. In all other cases, the risk of surgery far outweighs the theoretical, and extremely slight, risk of getting a joint infection because of the prostate..

 

[Celle]

They even go as far as recommending men to have their prostate operated on before the replacement to avoid any chance of a urinary tract infection afterwards. If every UTI could cause an infection in the replaced joint, that would be very worrying indeed.

@Al Zymers - Please give us a reference to where you found this information. In my 9 years on BoneSmart, this is the first time I have heard of this advice.

 

[Al Zymers]

They even go as far as recommending men to have their prostate operated on before the replacement to avoid any chance of a urinary tract infection afterwards. If every UTI could cause an infection in the replaced joint, that would be very worrying indeed.

@Al Zymers - Please give us a reference to where you found this information. In my 9 years on BoneSmart, this is the first time I have heard of this advice.

" The third area would be urologic issues. In men who have an enlarging prostate and urinary problems, where they are already having bladder dysfunction, many of them will say, "Well, I'll have my prostate taken care of after my prosthesis is put in", and that is really the wrong way. If the prostate is already at a point where it needs to be operated upon, then that surgery should not be delayed until the prosthesis is put in."

Prevention of Infections in Total Joint Replacements

 

[Celle]

Thank you for the reference, @Al Zymers .

The article makes it clear that prostate surgery is only recommended prior to a joint replacement, if the patient already has a pre-existing prostate problem. It isn't a general recommendation for all men.

 

[Al Zymers]

Thank you for the reference, @Al Zymers .

The article makes it clear that prostate surgery is only recommended prior to a joint replacement, if the patient already has a pre-existing prostate problem. It isn't a general recommendation for all men.

The only issues I have had with that recommendation is that most men old enough to have a joint replaced, usually have some prostate issues as well at that age. The issues may not be severe, but they do get worse over a period of years and they might have to have a prostate procedure after their joint is replaced.

 

[Celle]

@Al Zymers , since this is Cococay's thread and she is a woman, we have gone off topic for her thread.
I just wanted to establish that there is no need to listen to alarmist warnings about the possibility of post-op joint infections. They are rare.

If you want to discuss the issue of prostate surgery in relation to joint replacements, let's take it to your own thread, so we don't further derail this thread. OK?

 

[Sara61]

@Cococay I would definitely wait and see what the hospital decides to do, as if they cancel your surgery it is because they have no alternative but it also means that you will be on the top of the list for the next possible surgery, cancelling it yourself will put you back way further and might take many months to reschedule.
Maybe ask your Doctor for something to help with your depression, meanwhile, don't worry about trying to keep your posts " just positive on here " BoneSmart is for the good and for the bad, if you need to vent, feel free to do so, we are all here to listen and offer sympathy, I can tell you I vented many many times earlier on in my recovery. You are young and once you are fully recovered you will look back and be pleased you didn't cancel, I'm now 1 year post left knee surgery and now on a waiting list, to get my right knee done too xxx

 

[Cococay]

Thank you very much. This forum has become a lifeline in a sense. I am always on call for work and checking my emails almost obsessively- and I’ve noticed I check this just as much.
I appreciate your words also because I have worried that maybe I was becoming to annoying on here between questions and complaining-and I definitely don’t want to be especially seeing as how much I’ve got from everyone on here. So-thank you

 

[Jaycey]

@Cococay Now you know why BoneSmart started. Feel free to question and complain. We totally understand. Pre-op is an especially frustrating time. Add to the mix this darn virus - mega frustrating.

 

[Jockette]

Questions are always welcome, yours are good ones, and most likely others want to ask the same thing, so everyone wins. We’re glad you joined us!

 

[Cococay]

I sent a message to my OS -I guess I was “hoping” for reassurance it’s still on track. I got a call back from one of his PA’s who said “for now your surgery is still a go-but.... the hospital has cancelled surgeries through December 9th. Hopefully it won’t be pushed back more and yours will be ok on the 15th but—-we really won’t know -until we know”. So..... I was going to have my preop tomorrow but I rescheduled that for next week. Then...,,,,, 2of my employees tested covid positive this week. I’ve only been in contact with one and only a couple hours that I was meeting with her. It’s crazy -one of them had not one symptom and still doesn’t. The other has very minor cold symptoms-thankfully, but it does worry me. I don’t get tested for 6-8 days before surgery but I may test now too—- if for no other reason then if I did end up getting it I certainly don’t want to spread it to anyone else.
im trying to be ok with the realization that I likely won’t know if my surgery is a go until the day before.

 

[Jockette]

I’m sure all the uncertainty of COVID and upcoming surgeries is extremely stressful. I was majorly stressed out about my surgery and there was no covid back then. I hope it all works out for you.