Knee Infection* "Implant Complete!"

Jazzerguy

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Hi there. I just found this chat room and should’ve looked for it along time ago. I had a knee replacement 2 1/2 years ago. I suffered pain and it was discovered that I had bone fragments growing from the side of my patella. Last July I had them cleaned up with arthroscopic surgery and wound up with an infection 3 1/2 weeks later. I had a debridement surgery after that and was put on IV antibiotics for six weeks. Long story short, I still have an infection in my knee.

I am scheduled for a revision surgery in December and have been on oral antibiotics for a year. I get around but the worst part now is a bulge below my knee on the tibia. It’s swollen and very very sore to the touch and limit my activities. It’s creating a lot of pain and inability to walk well.

Any insight on the swelling or ways to control it?

Thanks!
 

sistersinhim

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@Jazzerguy, welcome to Bonesmart. You have certainly been through it with that knee. Would you please give us the exact dates of your procedures and tell us which knee it is? One of us will add this information to your signature. Knowing this will help us better advise you.

Are you icing and elevating your leg? That should help you to get rid of some of those swelling.
 
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Jazzerguy

Jazzerguy

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I had the TKR on 1/6/2020. Turn on the course of the year I continue to have pain on the anterior side of the knee. Eventually an x-ray showed calcium growth off the side of the patella. I had arthroscopic surgery last July 2021. It was a 45 minute procedure, but 3 1/2 weeks later I had a Mersa infection in the knee. I had a debridement within five weeks, followed by three hours of vancomycin daily For six weeks.

My blood results for sedimentation and creatine have been low and normal since then, but when the knee has been aspirated the synovial fluid is cloudy. I’ve also developed this bony like inflammation in the tibial plateau, where most of the current pain is. I am active, so I’m able to ride my bike. But walking and going downstairs are brutal. I ice after every exercise and wear elastic knee bands on both knees, as I have arthritis in the other knee.

I’m scheduled for a two stage revision in December

Hope that helps
 

Jockette

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Hi and Welcome!



I‘m sorry for all you been through. If you have a definite date for the upcoming surgery in December, please tell us and we’ll add it to your signature. :flwrysmile:

Here are some other member threads who have had infections, if you’d like to check them out:
 

sistersinhim

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@Jazzerguy, do you know your date in December for the revision?

Hopefully, your doctor will clean up all that inflammation when he does your revision. Is icing helping?
 

Annie5

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Any insight on the swelling or ways to control it?
So sorry to hear how much you’ve gone through might be something you’ve always done but do you put cold bags on it regularly?
I really hope you find a solution soon x
 
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Jazzerguy

Jazzerguy

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I ice. I stretch. I use Elastic knee braces. I mostly take Aleve every day in the morning and even medical marijuana for the chronic nature of my pain.

I’m just hoping that the bump on my tibia and all of the pain on the tibial plateau is related to the infection. That gives me some hope that the revision surgery might alleviate that, since that’s where most of the pain is now
 

hawk2go

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Hi @Jazzerguy. Are you a musician or a jazz lover?

I'm hoping you get into a surgery before January. If you enter "revision" into the Search box in the upper right, you'll get a list of the members who have chronicled their journey through TKR revisions.
 
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Jazzerguy

Jazzerguy

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Thanks for the kind thoughts and words!

I’ve read enough online to know that no one has the exact same symptoms. I can get through my day, but most days are different. Sometimes it’s easy and sometimes it’s hard. On the weekends when I exercise I typically need several days to recover for pain abatement. At this point most of the praying and problems are on my tibia. A large swollen area on the inside right below the knee and pain across the whole top of the bone. My knee is very warm to the touch, so I can only conclude that it’s all being created by the infection.
 

Flashlight

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jazzerguy, Could you get a second opinion from an infection control doctor? Do you know for sure the Mrsa infection has resolved?
 
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Jazzerguy

Jazzerguy

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I’ve had an infectious disease doctor working with my knee doctor. He prescribed vancomycin after the last surgery in August 2021. I took it for six weeks, twice a day, for an hour and a half each time through IV.

After my surgery, he prescribed oral antibiotics, which I’ve been taking twice daily since last August. I believe it’s kept the infection under control, but when I’ve had synovial fluid drawn from the knee it’s cloudy, indicating a bacterial infection that persists. The knee is also warm, swollen and painful, despite low blood markers.
 

Catalien45

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Hi, @Jazzerguy. First, I am SO sorry to read all that you have been through! You have really had a rough time. It sounds like you are a very active person, & a fighter. I’m convinced that makes a difference in this situation.

My TKR was nearly 1 year ago. I was doing well recovering, but at around 5 weeks on, I developed an infection in my incision. Long story short, I spent 6 days in the hospital, & had a second surgery with a general anesthetic this time. My Dr cleaned out everything thoroughly, and, replaced the liner in my new knee, the infection had not spread to the bone. I was fortunate, as this was in the middle of a surge of the latest Covid outbreak, and bad in the Denver area, where we live. But even with that, I received excellent care. To this day, I don’t know how the nurses took such good care of everyone there. I’m wondering, did they replace your liner at any time? My Dr said he didn’t want to take a chance of any infection remaining there, possibly spreading. This was last November, & so far, I’m doing well. I’m an active 77 year old female ( as my grandson would say…” Nearly 78, Grandma!). I was on 6 weeks of IV antibiotics, then 3 months of oral ones. We had a strict regime of 3 infusions daily, the first one at 6 am. My husband & I walk weekdays for a little over a mile, & are working hard to be sure we get enough sleep at night, and eat well. My nurses in the hospital stressed lots of protein for healing. During the IV antibiotics, my appetite vanished, but did return. I still try to focus on the healthy eating, rest, & exercise. My balance is wonky these days, so I’m working on quad strength, which my Dr said helps with that. I have learned to take my time, & try to avoid stumbling. ( I tend to be a bit of a klutz, anyway).
I’m so glad you found Bonesmart! There is so much help here, so many people with wonderful advice. My Dr & his staff are wonderful, and they have an excellent helpline source where I can call at any time & ask questions. But there is really something valuable about being able to talk to folks who have also had this surgery. I have learned so much! I was pretty naive going into this. My knee was badly bone-on-bone, & I was ready, to be sure. But it sure helped to have this site, & the help & encouragement that I found here. And just personal experiences, & tips from others. I do hope & pray that you will find resolution soon. I’ve been off for a while…. Our summer has been very busy, we had a large garden, canning & freezing ( which I Love to do!), a family visit & drive to Texas (long overdue!), and, we had the privilege of having our 7 year old grandson with us 2 days & nights most weeks while his folks both worked from home. He’s a delight, lots of fun, but, boy, did we get tired! But we loved it. Things are slowing down a bit now, so I’m trying to get on at least every few days. I’ll be watching for your posts, & hoping to see some good news for you. I hope today is a good day for you.
 
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Jazzerguy

Jazzerguy

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Thank you so much for your thoughtful response. It is interesting how the support and feedback of others creates an emotional and psychological support that we need.

After I developed an infection after my arthroscopic surgery, I had a complete debridement. They did replace the plastic piece below my patellar, and I had six weeks of antibiotics. But none of that eliminated the infection. A year later, and have taken antibiotics every day. I think that’s some point maybe the doctor was hoping things would clear up.

I sure hope my revision surgery enables me to get back to her mom mobile life. I am happy that you had a great outcome and that you were back to being active and enjoying life. That’s the kind of role model I need from an attitude perspective. I am anticipating success.

We are going to New Zealand in late November on a walking tour that I’m going to find a way to struggle through. We originally scheduled it during Covid and really want to get it done. My revision surgery is December 19 the week after I return.

Thanks and all the best to you
 
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Catalien45

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Hi, @Jazzerguy….just wanted to say, I totally agree. The support & experience of others who have had a TKR is so very valuable & encouraging. I was such a dummy, I didn’t even think of this as Major surgery until someone on this forum stated it was. I’ve had abdominal surgeries through the years, and, I suppose in my somewhat stubborn mind, That’s what I viewed as “Major”. I fought having it done for a long time, much to my husband & daughter’s disdain. Finally, the pain was so bad, & so constant, I recognized it had to be done. I’m very fortunate… they have both been so very supportive. We’ve always referred to our daughter as “ the little general”, she stays on top of us both when it comes to our health. She’s small… 5’2 or so, about 100 lbs soaking wet… but don’t give her a hard time! :)

Wow! I’m impressed with your planned trip. We did finally make a trip down to central Texas this summer to visit family there. We made a road trip out of it, & really enjoyed it, there is a lot of beautiful country & wildlife the as we go. And the visit was Wonderful! ( and lots of good food) I bet some of the more experienced members can give you advice as to icing, elevating, etc, to make your knee more comfortable. I remember someone mentioned some ice packs that you break open and use. You might want to explore that before you go. It sounds like you have some hiking to do, so any advice you can get from some of these folks might be handy. And, you do have some time to get ready, as to your knee. That’s where this forum can be very helpful. It sounds like quite an adventure.

Welll, I should go & get our lunch started. I’m a bit of a “slug” this afternoon… we got our flu vaccine on Monday, & our Covid Booster yesterday. I shopped for groceries today, & my body is saying “ slow down!” The shot seems to be having some effect. So, lunch, I’ll finish up some tomatillo enchilada sauce from our garden tomatillos, & then take it easy. Hope you have a good day. And don’t hesitate to use this forum as a good source of advice…. There are plenty of people on here who will be glad to help.
 
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Jazzerguy

Jazzerguy

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Hi Cait. (That’s my nieces name!)

Sorry that I just now saw your reply.
I wish I could report that things were markedly better, but it’s not the case. Recently saw some x-rays that showed the impact of the infection on my tibia below the knee. The surgery can’t happen soon enough, but we are going to muddle through the trip to New Zealand as I could not move the date up.

Hope you’re doing well!
 
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Jazzerguy

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So happy my fingers accidentally brought this website back up on my phone today .

I am one month out from the knee removal. It's my third operation after an implant in Jan 2020, and an infection and a debridement last August.

Each surgey has been different. Looking back, my implant was almost easier than what's followed. The soft tissue pain has been profound during my current healing process. Especially in the IT band and back of my knee. I certainly hope it abates.

I'm doing my second Vancomycin protocol and have articulating anti bacterial spacers in the knee. My blood work reveals lowering CRP and sediment action numbers. I remain optimistic and determined and have good docs.

I'm encouraged by stories of success here. Any responses are appreciated. Cheers!
 

Jockette

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My revision surgery is December 19 the week after I return.

I am one month out from the knee removal. It's my third operation after an implant in Jan 2020, and an infection and a debridement last August.
Hi and Welcome back!

Please confirm the dates of the surgeries above, they are not consistent with the dates we have in your signature, and we want to be sure your signature is correct.
 

Jockette

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The soft tissue pain has been profound during my current healing process. Especially in the IT band and back of my knee.
I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Just keep in mind all people are different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

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!)​
If you want to use something to help heal the incision,
BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.​

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 to these pages on the website

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.
 

Jockette

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And, by the way, I copied Post #16 above, that you posted in another thread, as it’s a good update and is part of your history. :flwrysmile:
 

Jamie

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@Jazzerguy …. I’m glad you found BoneSmart again. Given all you’ve been through so far and your upcoming revision recovery, I think we can help you get through any challenges that may arise.

You’re right that it can be quite demanding to deal with a persistent infection. But the improving bloodwork is a very positive sign. It sounds like you have an excellent medical team on your side and that goes a long way when dealing with infection.

Are you under the care of an infectious disease specialist along with your orthopedic surgeon? We find this helps in most cases.

The IT Band issues can be helped with some exercises and possibly the help of a good physical therapist. If you’re having pain at the back of your knee, that is pretty common. Be sure to ice that area as much as you can. The ice really helps with pain.
 

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