Knee Infection* getting there

[Crowwood]

I am now home after receiving surgery on the 22nd December to take out the implant infected by Streptoccocus agalactiae. I am receiving 1g Teicoplanin every day intravenously by a nurse from a local NHS service, and plans are to have this treatment for at least 6 weeks. My knee is braced externally and ROM is limited, so far the pain is not too bad although getting comfortable at night is a challenge. I am getting about on crutches as knee is only partially weight bearing. I can only just cover short distances around the house. My main concern is keeping the muscles in my braced leg is reasonable condition for this long period. So far so good.

 

[Pumpkin]

@Crowwood
Welcome back, sorry to hear you have an infection and a are going through a 2 stage revision.
Glad you do not have too much pain.

My main concern is keeping the muscles in my braced leg is reasonable condition for this long period.

Ask your surgeon for a few exercises you can do in bed while you are healing.

Here is your copy of the Knee Recovery Guidelines, the articles are short and will not take long to read.

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:

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rest​

elevate​

ice​

take your pain meds by prescription schedule (not when pain starts!)​

don't overwork.​

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

​

the BoneSmart view on exercise​

BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

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Activity progression for TKRs​

6. Access these pages on the website

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Oral And Intravenous Pain Medications​

Wound Closure​

The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling
Heel slides and how to do them properly
Chart representation of TKR recovery
Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds


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 the 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 the member’s history before providing advice, so please post any updates or questions you have right here in this thread.

OneStep App Request

Since December, BoneSmart has offered a number of pilot tests and special promotions with our partner, OneStep. Members were allowed to use this unique app at no charge to help us evaluate the program’s effectiveness for prehab and recovery for joint replacement patients. Feedback has been...

bonesmart.org

 

[Rubyroo]

@Crowwood You have been through a lot with your left knee! I am so sorry! I hope things continue to improve & you have no more issues!

 

[Crowwood]

Yes it has been a bit of a saga ! Knee replaced in 2016, then infection and DAIR in September 2019, six weeks of Teicoplanin and then onto oral Amoxycillin for nearly two years. But none of that got rid of the infection which flared up whenever I stopped taking the penicillin. Finally, consultant brought me in for the two stage revision after latest flare up in December. NHS provides a daily visit from a nurse to me at home to drip in the Teic and check my stats etc....a brilliant service. CRP has dropped to 10 now from around 240, but some concern about a high potassium level. One of the biggest problems I have is that the surgery has kicked off sciatica, which makes sitting or standing very uncomfortable and it is hard to do the stretches that would help with my leg as it is and with the brace in place.

 

[WFD]

Do you know how your knee got infected three years after the TKR?

 

[Starsfan22]

@Crowwood , you and I have dealt with the same issues..... I'm hoping we're both on the other side soon. Keep us updated and ask for help or support.

 

[Crowwood]

Nobody is sure how the bacteria got in but my theory is that it was when I fell off my bike and cut that knee. I fell on to a farm track used by cows and the Steptococcus Agalactiae has some association with cows and gives them mastitis, although it also lives on humans quite naturally .

 

[Crowwood]

I am now three weeks after having stage one of the two stage revision of my left knee. I have an external brace on the knee and a spacer inside. When I move around, the knee makes lots of clicking and clunking noises which is a bit alarming. Everything seems to be in place and the pain is now very manageable. I am trying to get some exercise on it, using crutches and doing a few stretches as sciatica down that left side is a nuisance. Should I worry about doing any damage to the spacer bit ?

 

[Sara61]

Clicking/clunking knee joint after surgery

Revised March 9, 2021 by Jamie Many patients who undergo knee replacement surgery will describe noises that come from their replaced joint. People commonly mention a clicking or clunking coming from their knee replacement when they walk, and they often worry that something is wrong with their...

bonesmart.org

 

[Jaycey]

@Crowwood A spacer is not going to be a "perfect fit" so it may indeed be noisy. It may also be uncomfortable - especially if you are trying to exercise. Gentle stretches are fine. But I would not try and force that knee right now. It has enough trauma trying to fight off the infection.

You will notice that I merged your newest post with your original recovery thread. For several reasons, we prefer that you only have one recovery thread:

• That way, we have all your information in one place. This makes it easier to go back and review your history before providing advice.
• If you keep starting new threads, you miss the posts and advice others have left for you in the old threads, and some information may be unnecessarily repeated
• Having only one thread will act as a diary of your progress that you can look back on.

Please post any updates, questions or concerns about your recovery here. If you prefer a different thread title, just post what you want and we will get it changed for you.

If you need an urgent response to a question, just tag a member of staff.

Many members bookmark their thread in their computer browser, so they can find it when they log on.

 

[Crowwood]

thank you, that is reassuring. I wonder if you have any advice re the sciatica type pain I am getting down that left side and in my butt when sitting

 

[Jaycey]

As a person who suffers from sciatic pain you have my sympathies. I had a major sciatic flare post LTHR. I found gentle Hamstring stretches from a seated position helped. In fact I still do these daily while I am at my desk.

Ice may also help - like sitting on an icepack.

 

[Starsfan22]

@Crowwood , my spacer was noisy too. The noise makes you think it's going to fail but it won't. It seemed to come and go and got better with time. I was told not to do strengthening exercises with the spacer in place, just gentle stretching, ankle pumps and rolls. Your goal is to heal, that's your job. I was only allowed 50% weight bearing on the spacer so strengthening that knee was hard. As it healed for 8 wks pain was almost gone and getting around with the walker was easy.

The antiobiotic infusion process was a major issue once I developed Redman syndrome + other side affects to vancomycin. Thank goodness I got past that.

 

[Crowwood]

thank you both for very useful advice. I will certainly try the exercises......

 

[Crowwood]

I met with the consultant yesterday. CRP now at 6. He is very happy with the progress made and I am being taken off the intravenous Teicoplanin on friday, after six weeks treatment, and put back on oral antibiotics. Unfortunately he cannot give me a date yet for stage two of my revision surgery but I am on the urgent list so my fingers are crossed for a short wait. My knee brace has been altered to give me a full 90 degrees of movement now, it was set for 40 before. That will certainly help. I have found the Teicoplanin very difficult to manage with nausea and tiredness both challenges so I will be pleased to stop having it. It has done its job thankfully.

 

[Jaycey]

@Crowwood Sounds like you are making good progress. Fingers crossed you get that surgery date soon!

You will notice that I merged your newest post with your original recovery thread. For several reasons, we prefer that you only have one recovery thread:

• That way, we have all your information in one place. This makes it easier to go back and review your history before providing advice.
• If you keep starting new threads, you miss the posts and advice others have left for you in the old threads, and some information may be unnecessarily repeated
• Having only one thread will act as a diary of your progress that you can look back on.

Please post any updates, questions or concerns about your recovery here. If you prefer a different thread title, just post what you want and we will get it changed for you.

If you need an urgent response to a question, just tag a member of staff.

Many members bookmark their thread in their computer browser, so they can find it when they log on.

 

[Cjackso21]

So sorry about all of these problems! Despite all of the surgeries I have had, no infections. Just remembered to take my antibiotics before my teeth cleaning last week. Will pray you get your surgery soon and the infection goes away!

 

[ski_bum]

@Cjackso21
I also was told by Surgeon & Dentist to take antibiotics before even just Teeth Cleaning.
It is all over whether Antibiotics is required.
One site said, infection from Teeth goes straight to knee joint. I don't know anything, not a Dr.

 

[Crowwood]

I have been given the date of 1st April for my surgery, the second part of the two stage revision. The NHS here is very stretched with staff absences and burn-out so I am grateful to have something to put in my diary. My last intravenous antibiotic happened on monday and the line is now out. I found the Teicopanin really exhausting so am pleased to be off it.

 

[Catalien45]

Hi, @Crowwood ... I’m sorry to hear about your infection. It sounds like you are handling it well, and it’s good that you are now on schedule for everything to progress. I had an infection in my incision, & had a cleanout surgery & replaced liner in November. I’m fortunate, the Drs are pretty sure it was not deep, but “ dissolvable” sutures that my body didn’t like. . Like you, I was very glad to be done with the IV antibiotics. My Infectious Diseases Dr told me that they do mess with your appetite, and, they did! Fortunately, I’m now on oral antibiotics and happily cooking, & enjoying food again! This has been quite the adventure, for sure! It’s So nice to not be hurting all the time. I only use my cane when shopping, or occasionally. Looks like my grandson (6 1/2) will be inheriting one of my canes before too long. He had asked me, when I no longer needed them, could he please have one for a hobby horse..isn’t it like a child to put a happy slant on things?. Good luck on your revision surgeries, and I will be looking for good reports from you soon. April will be here before we know it!