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Knee Infection* DSJ's knee Saga

DSJ

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Part 1.
My initial left TKR was in November 2018.
I went home the second day after surgery.
I had lots of pain and swelling.
Lots of painkillers and cryo/cuff time.
I started physio at the hospital about 3 weeks later.
The PT took a look at my incision and called in the nurse who specializes in wound care. There was a spot about the size of a dime that looked suspect.
She manipulated it until it popped. It was healed on the surface, but not underneath. There was lots of drainage.
They packed the wound, gave me a script for antibiotics and sent me home.
After that I got a daily visit from a nurse to change the dressing. It was still draining a lot of synovial fluid. The more active i became, the more drainage.
I continued with physio for a six week program.
By the end of February, I was easily walking a mile at a time and was pretty much pain free.
 
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DSJ

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Part 2:
Mid March 2019 .
Despite functioning well and neing pain free, my wound would not heal and was still requiring daily dressing changes. So my surgeon decided to go in and take a a look.

After consulting with another surgeon, they concluded that i had a commucating sinus, which is considered to be a telltale sign of an infection. They took some cultures, replaced the plastic parts of the prosthesis.
I was up and walking unaided the next morning.
It took three days for the cultures to come back. The news wasnt good. My implant was infected with a particularly tenacious bug.
I was transferred to a surgeon who specializes in revisions and an infectious disease specialist was brought in.
 
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DSJ

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Part 2 , continued

The decision was made to do a 2 stage revision. My surgeon's plan was is to use a regular prosthesis rather than a cement spacer.
This round of surgery involved removal of my implant and agressive debridement of the knee cavity. Then the surgical team temporily closed me while they changed and scrubbed again.
A new knee was then installed using glue that was diluted with antibiotics. This would make it easier to remove during the next stage.
I had nearly full range of movement the next morning. Pain wasn't too bad, with nothing more potent than tylenol in the days afterward.
I went home a week later with a PICC line in me. I was prescribed a combination of iv and oral antibiotics.
I went through the physio program again, this knee went full-lock straight very easily and was at 125deg. within a few sessions.

After four weeks of iv, my system wouldn't tolerate any more and my bp spiked to 230/130.
After a brief hospital stay, the PICC line was removed and i continued on oral antibiotics until September 2019.

Swelling in my knee continued until May.
My knee was functional, but it was clunky and painful to walk for any distance.
 

Roy Gardiner

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:welome: to BoneSmart

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 these pages on the website

The Recovery articles:

There are also some cautionary articles here


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 a 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 history before providing advice.
 
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DSJ

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Part 3.
June 2020.
Follow up appointment with my surgeon, and we made the decision to proceed with stage 2 of the revision and finalize this thing.

I made appointments for various test in order to prepare for the operation. I had blood tests, bone scans, and xrays, as well as consultation with the infection specialist.
I had lost 40lbs over 8 months and was able to walk a mile a day.
In July, he drew fluid from my knee which was tested for infection , results were clean.
2 weeks later my knee became inflamed and swollen. I could not put any weight on it.
I went to emergency and they admitted me.
My Dr. drew another sample and this one showed an infection. It was a different bug than the first.
On August 9, they operated on me again, repeating stage 1 of the revision.
I came home with another PICC line and more iv antibiotics 24/7.
Im tolerating this one much better than the last time. If all goes well it should come out this week.
A nurse visits daily to change the iv bag and monitor my vitals.
Im doing the physio program again, not pushing too hard, but I'm working on maintaining flexibility while healing.
My knee is still swollen quite a bit, so my wardrobe consists of shorts and sweats.
 

Pumpkln

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@DSJ,
Welcome to BoneSmart, glad you joined us! :welome:

You have been through a lot with your knee, sounds like you had an infection right from the start.
Your team appears to be on top of everything, :fingersx: for a successful stage two of your revision and placement of a new implant.
Glad you are tolerating this round of antibiotics and are able to be at home with nurse visits.

Here is a brief over view of what your surgeries you had, hoping I captured everything. If you have the exact dates it will help us better advise you, if not that is OK for the more remote surgeries.
A moderator will add them to your signature when you post them.

TKR November 2018, infected incision
March 2019 Stage 1 revision for infection, new implant with antibiotic infused cement placed
August 9, 2020 Stage 1 revision repeated, cement spacer
September 2020 Stage 2 revision to be scheduled
 

_Annie_

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Wow DSJ, you’ve really been through it. I hope things will turn around now, and you will fully recover. You didn’t mention your feelings about all this, but I can imagine that this would wear you down. Hang in there.
 
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DSJ

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Thanks for the welcome! I dont know why it took me so long to find this place.

Heres the corrected timeline with dates.

TKR November 21, 2018, infected incision
March 13, 2019 Stage 1 revision for infection, new implant with antibiotic infused cement placed
August 9, 2020 Stage 1 revision repeated, amother implant with infused cement.
September 2020 Stage 2 revision to be scheduled
 
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DSJ

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Wow DSJ, you’ve really been through it. I hope things will turn around now, and you will fully recover. You didn’t mention your feelings about all this, but I can imagine that this would wear you down. Hang in there.
It's easy to get down. I was planning on 6-8 weeks off work. After a few aborted attempts at returning, that has turned into at least 2 years.

This last stay in the hospital was particularly tough due to covid visitor restrictions.

Ive used my time to research and learn a new hobby that doesn't require heavy lifting or standing.

I recently bought a really nice razor, some fancy shaving soaps and a brush , along with some different aftershave lotions. Its a little thing, but it makes me feel good, and i look forward to shaving now instead of it being a chore.

Above all, I've gained an understanding of what i can control and what i cant. Theres no use stressing over the things you can't control. Its a bit of a stretch, but my current goal is to go moose hunting in 5 weeks.
 

newlybionic

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I hope your surgery for the Stage 2 revision goes well and you’re back on the healing path.
 
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Peaches0000

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Wow DSJ, I can’t even find the words to tell you how much I admire your attitude and commitment to getting better. You have been through pure torture with your knee. You have a great attitude and I wish you a great recovery and pray there are no more infections!
 

_Annie_

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Nothing like a furry friend to make you feel better :)
 

Peaches0000

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Awww, your best buddy, helping you get better, Dogs are such great company!
 

PegGar16

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and your I like your 5 week goal and your furry friend. A lot of animal lovers here :) Mu infection ordeal was long also but we got rid of the infection., Keep up the great outlook!!
 
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DSJ

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A bit of a setback today. My ID doctor called and rescheduled tomorrow's appoint for two weeks.

The plan was to get rid of this (expletive) picc line and IV pump that's been attached to me for five weeks and transition onto oral antibiotics.

It's a bit depressing, but I guess I'll just roll with it.
 

WhenImOld

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A bit of a setback today. My ID doctor called and rescheduled tomorrow's appoint for two weeks.

The plan was to get rid of this (expletive) picc line and IV pump that's been attached to me for five weeks and transition onto oral antibiotics.

It's a bit depressing, but I guess I'll just roll with it.
Oh no! Hopefully the two weeks will fly but I know they won't seem like it when you're waiting!
 
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PegGar16

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nd your I like your 5 week goal and your furry friend. A lot of animal lovers here :) Mu infection ordeal was long also but we got rid of the infection., Keep up the great outlook!!
Sorry about this confused message...I am typing with a cast on the hand and it hits buttons I don't mean to...LOL

I know it takes a lot of patience to go through this ordeal. The important thing is to make sure the infection is gone for good. You don't want any more repeats :)
 
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