TKR Incision opened when staples removed<

[GingerP]

@fours2many I'm so sorry that you have your incision open after tkr. I had just a little spot that opened about 2 months after the staples were removed. Mine was like a staple hole that the scab came off, but it went much deeper than any of us knew. My fluid was serum only but it became a very long process of healing. Please be vigilant with your open incision. I realize there are surgeons who seem to take a hands off look at things after surgery and don' t follow up with patient care like they should - I had a guy like that and had to ask to have others look at my situation to make any progress in healing.
Be your own advocate - check out resources to be certain that there isn't more going on. I'm not trying to alarm you, but be practical so that your trust of the situation doesn't put you in jeopardy down the line. We know our bodies better than the surgeon and can see the changes, feel the pains, aches, etc they can't know. All can be signs of things that need attention. Late in the healing of my open incision, the wound dr asked me if I was taking a zinc supplement. Nope, didn't know that, so have been taking it since I learned that and into this tkr. My new surgeon felt it was a very good idea to take it as well.
Praying that your infection is held at bay with the antibiotics and your healing continues. It is one day at a time. Little by little, you will get better.

 

[fours2many]

waunaking, I’m so sorry to hear you are going through this too.
I’m glad your OS handled it properly. I know we can be impatient, I definitely am. I want to be driving my car, walking, swimming...

So, you have 6 more weeks to rest that knee! Trying to take it one day at a time. I know I’ll get there, it’s just taking a little longer. I hope by resting your leg, you heal quickly1

Thank you for sharing that with me. My incision opening is about 6 inches. It starts healing, then just breaks back opened. As of this am, it looks as if it’s holding. I still have butterfly bandages holding it together.

I didn’t know about zinc. I’ll have to ask about that. I’ll ask my rheumatoid dr though. A lot of things aggravate lupus. I have an appointment coming up.
Thank you

OS drained my knee yesterday. It was very painful when he was doing it. I actually screamed, cursed and begged him to take the needle out. I have to admit though, my knee feels so much better. I was able to go 6 hours between pain meds all night, and even then it wasn’t awful at 6 hours. The persistent ache is gone, even the tightness is less.
He told me to ask my gp about a water pill. I’ll have to ask.

 

[amymj]

That sounds horrible. I hope things continue to improve for you.

 

[SusieShoes]

What a painful procedure, but good that it produced some relief. I'm crossing my fingers the fluid stays gone and you can continue with a more normal recovery. The big danger is infection, of course. Did your OS say he was going to culture the fluid?

 

[fours2many]

The big danger is infection, of course. Did your OS say he was going to culture the fluid?

Hmm, he didn’t say. I sure hope he’s going to. I know it was very bloody. OS actually tried to cover the syringe so I wouldn’t see it. I expected it to be bloody, so that didn’t bother me. I was more concerned if it was cloudy, which it wasn’t. I’ll have to call and ask if he sent it out.
I agree. Trying I’m everything to prevent infection.
Thank you

 

[sistersinhim]

I had to have my knee drained after my first lateral release and scope do to aggressive PT. I know what you went through. It HURTS big time! I'm so glad you had it done and it was worth it now to have such less pain. Hopefully, with the less pressure, your incision will close.

 

[fours2many]

Hmm... my husband picked up my prescriptions today. I took one of the antibiotics. I realized it looked different than the last medication OS had me on. It is called Levaquin.

I did a quick search of it, since I have a lot of allergies.

The first warning states Tendon problems (tears), especially in people who take corticosteroids. Umm, yeah... I already swallowed the pill. Don’t Dr read interactions? Shouldn’t the pharmacist have caught this? What do I do now?

 

[sistersinhim]

I would call my OS and leave a message for the on-call doctor to call you back. He needs to tell you what to do. I'll tag @Josephine. She knows much more about this than I do.

 

[Jamie]

Get in touch with your doctor's office. On the weekend, you may get the answering service, but tell them you need to talk to either your doctor or the one on call. If you have other health issues that might impact taking this new med, you need to get things straight before taking any more of them. Insist on talking with someone now. They should have informed you that your medication was being changed. You can also call and talk directly to your pharmacist while you're waiting on your doc to return your call.

You also do need to ask about whether they are culturing the fluid. You would think that would be automatic, but it's not always so. Plus, since you've been on antibiotics, the culturing might not yield accurate results.

At some point, you might want to have a consultation with an infectious disease doctor or someone who specializes in wound care. Many times surgeons will pull one of these specialists in, but it sounds like your doc is not too used to dealing with infections.

 

[GingerP]

@fours2many , I was on levaquin and I must say I never hurt so much in all my tender spots than any other time. Dr told me that many people have that reaction and with all the other things you are dealing with, please use the guidance others have suggested.
I did have some fluid taken out and cultures never showed anything much because I was on some sort of antibiotic most of the time. I was always told it was low grade infection like we all have on our skin.
Since I never had a fever, redness, oozing, or anything else I was almost certain that my joint wasn't impacted but it became absolutely apparent once I had a test done August 21 that the joint was clear.
Be vigilant and advocate for yourself - ask, ask, ask questions. Write them down at home when you think of them. I should have been doing that sooner, but relied on the 'experts' to know best what to do.
Believe me now with the second tkr, no assumptions - I learned my lesson. Luckily, this OS is very much concerned that I heal well and do well in recovery and told me to never be afraid to call and not to wait until my next appointment if I have 'any' concerns whatsoever.
Praying you get guidance from your health community.

 

[Josephine]

It is called Levaquin. The first warning states tendon problems (tears), especially in people who take corticosteroids. Umm, yeah... I already swallowed the pill. Don’t Dr read interactions? Shouldn’t the pharmacist have caught this? What do I do now?

I very much doubt that one tablet would cause any problems. That side effect is more about long term use of it.

However, Drugs.com says this
Levaquin may rarely cause tendon damage (and) your risk for tendon problems is greater if you are over 60 years of age or if you are taking corticosteroids (such as prednisone)

Are you taking prednisone?

 

[fours2many]

Are you taking prednisone?

Yes I’ve taken prednisone almost every day for 30 years. I have lupus. I took another one last night, since I never got a call back. An infection is worse to me than tendinitis. I did wake up in pain all over, shoulders, knee, ankle, hands... entire body aches. Although we are getting a storm front through and I feel worse when that happens.
I’ll try leaving a message for OS again today.

 

[fours2many]

@GingerP
Did you hurt everywhere? I’m hoping it’s the weather and not the antibiotic. I think I officially had enough of this last night. I cried and cried and cried. I don’t know how you made it through a year. If I could just see a glimpse of improvement... or even be able to get out of the house and enjoy myself fo even a moment, I think it would help my spirits.
On top of everything, I’m trying to wean myself of the Percocet. OS said I should be off them by now. I said even with my incision opened? He said well he’d give me 60 more, then that’s it... I think he’s hoping it’s closed completely by then. I had to take an extra one last night. The pain all over my body actually woke me. OS said to see my gp and try a water pill. If this isn’t closed in 1 week, I’m going for a second opinion. If OS doesn’t call back today, I’ll call my gp. See what he can do.

 

[GingerP]

@fours2many , yes I have tender spots in my shoulders and elsewhere and I pretty much felt like I had been run over by a truck while taking levaquin.
You have other health issues, so please DO consult with your GP and OS to be certain you are getting the best care.
I'm so sorry that your incision has opened. I too would be checking with someone else. Do you know if there is a wound clinic or wound nurse or doctor you could check with in your area? I didn't realize that our local hospital had a wound nurse who could assess my problem until I was toward the end of my process. I actually found out that one of my night nurse staff was going to be taking on that role in our hospital in a few weeks. Our town is a population of about 4400 people, so that is really terrific. My surgeon for my first knee problem I don't think really knew what to do with my opening. Even when I told him that the wound clinic had measured a tunnel of 8 cm, he asked how they found that out. I told him that there had to be someone who had some surgery experience that must know what to do. His ego or whatever you want to call it, didn't make him think he ought to 'ask' anyone else in the surgical staff about how to help me, so a second surgery of $17,000 later, I still had the same outcome for what he was to repair. I told him it was time for someone else to take a look at me. He and I had no luck. Reluctantly he agreed. After, he pretty much gave up any control on my care to the wound clinic instead of taking a partnership role - since it started with him suturing me up.
Advocate for yourself. You know how you feel and what does not seem 'right' for you.
Praying you get some answers from your calls and questions. You do deserve to have some information to help you have some piece of mind.

 

[Pumpkin]

fours2many,
If I were you, I would call my GP in the morning, and tell them about your incision. Ask for a wound care consultation, you are at the stage where you need a wound care specialist, and perhaps an Infection Doctor (ID) to take over the care of your incision.

 

[ACDCJen]

Sorry you are dealing with this. When the stitches were removed after my second TKR, the nurse was awful and my incision opened up a bit, maybe a few inches. Mine did become a superficial incision infection. I would say to keep your doctor informed and if it starts to cause a hole, go in ASAP!

Good luck!
Jen

 

[SusieShoes]

I second the advice to get a wound care doctor involved. These specialists have the training and interest to deal with your situation. I saw a wound doctor after my hysterectomy led to a wound opening and infection. He was a former surgeon and did a great job. As GingerP points out, many hospitals and communities have these specialists and they are worth seeking out. My insurance covered the wound specialist and I would think most do.

Your GP or the OS can refer you to the wound care specialist. An infection doctor is also a good option.

Sadly, we sometimes have to take the bull by the horns, so to speak, to get results. Once you find yourself in the hands of a medical professional who is working with you to make you better, you will feel so much better! Better about your health, and better about just the day to day things of life. Going it alone is just soul-draining.

Please let us know what you and your GP or OS decide to do.

 

[sistersinhim]

I agree, please find a wound specialist. You need this taken care of as soon as possible.

 

[fours2many]

Going to my GP appointment. Wished me luck! I have an hmo and need a referral to a wound specialist. Need some prayers. So tired of living like this. I need some hope!

 

[sistersinhim]

Please let us know what you find out. You definitely have lots of prayers from your friends on BS!