Lounge Doctor

Knee Infection* Infection at 7 Months Post Op - Back to Crutches

Cococay

member
Joined
Oct 21, 2020
Messages
241
Age
47
Gender
Female
Country
United States United States
I am so sorry to hear this. That has to be incredibly scary. Can I ask a did you feel feverish or any symptoms at all? It’s so scary to think infection can creep up out of nowhere. You are in my Prayers
 

Jaycey

FORUM ADMINISTRATOR
Administrator
Joined
Jan 27, 2010
Messages
34,986
Location
Yorkshire
Gender
Female
Country
United Kingdom United Kingdom
I’m trying to get a realistic idea about what/how much I’ll be able to do.
Unfortunately there is no way to predict how you will react to the treatment and how fast the antibiotics will eliminate the infection.

Also sounds like stairs and driving may be a problem. Are you in the position to take the time off work?
 
OP
OP
M

Mrs. Ciz

member
Joined
Jul 24, 2020
Messages
219
Age
55
Gender
Female
Country
United States United States
@Jaycey
I had accrued a ton of sick leave over the years, but I used 6 weeks at the beginning of the school year with my first BTKR. I have 5 paid weeks left. Then I’ll move to the unpaid 12 weeks FMLA leave. So I have 17 weeks with a combination of paid and unpaid. We can make it on my husband’s salary if we need to. Thank goodness we just paid our very last university tuition bill! The summer months won’t count against my sick/FMLA leave. There are 13.5 weeks left in the school year. I just hope I’m all better by the beginning of next school year, or my job will be at risk.

@Cococay
Yes, this came out of nowhere. I had my BTKR on July 6th and was released from my surgeon on Nov 10th. At that point everything looked good. The right leg wasn’t getting its range of motion back as quickly as the left (especially extension), but it has lagged behind since day one and was plagued by tight hamstring issues. I kept reading no two knees heal the same, and it takes a full year to recover, so neither my surgeon nor I thought twice about it. Then I overdid it Thanksgiving weekend (didn’t everyone!). I got some swelling. And at some point that weekend I hit the coffee table leg with my left shoe and stumbled. That really made my right knee sore. I got a sore bump below my knee on the front medial side. It was super tender to touch and a red roundish mark appeared. I thought it was just a soft tissue injury because surely a little stumble wouldn’t ruin the implant. By mid December, the bump had gone down, tenderness had abated, and the red mark had faded and peeled. Good - I thought that confirmed that it was all soft tissue related. But the tenderness, lower leg swelling and red mark came back in mid January. I’d had a really busy day running all over my 3 floor school, so I figured the swelling was because of that. I had my school nurse look at it. She said then that I should probably get it checked. But again, a couple of days later, swelling went down some, red mark faded and peeled, tenderness subsided. However, I did then make an appointment for March 2nd with my GP. I needed a physical anyway and would talk to her about it. It seemed so minor, I didn’t want to look like Chicken Little - “The sky is falling! The sky is falling.” But then it happened a 3rd time last week. I had a hard time walking for the first half of the day due to the discomfort, and my lower leg was visibly swollen. Red mark was there but very light. The school nurse saw me hobbling, saw the swelling and insisted I go to my surgeon to get checked. She thought it was a blood clot/DVT. So I called, and they squeezed me in for the next day. My appointment was with my surgeon’s PA. He hemmed and hawed over my leg because it doesn’t look that bad (just a little swollen). But he did agree that it was odd. He also noticed that the extension was worse than it was on Nov 10th. It was hard for me to tell. I just thought my left was progressing so much faster and the right had stalled that the gap in ROM between the two was getting bigger/more noticeable. But ROM in the right had actually decreased. So he consulted with my surgeon. They decided to start with xrays and bloodwork. Unfortunately they knew immediately when they saw the xrays. The infection has already entered both my femur and tibia. They could see the changes to the bones on the X-ray. They grilled me on dental work, open wounds, etc. trying to figure out what sparked the infection. (Only 2 little things I could think of after the appointment - an ingrown hair in my pubic area and a tiny scab on the inside edge of my nose that keeps getting irritated - both totally normal things that I didn’t think anything of at the time, but one of them may have been the cause.) At this point in my appointment, the surgeon took over, and things went into hyperdrive. Explant surgery was scheduled, blood work and CT scan orders/scheduled. I held it together until I got in my car, and then I bawled.
 

Jaycey

FORUM ADMINISTRATOR
Administrator
Joined
Jan 27, 2010
Messages
34,986
Location
Yorkshire
Gender
Female
Country
United Kingdom United Kingdom
I just hope I’m all better by the beginning of next school year,
Let's take it one step at a time. Sounds like they are moving quickly - that's great!

What's the actual date of your phase one op? I'll put it in your signature for you.
 

Celle

MODERATOR
Moderator
Joined
Nov 19, 2011
Messages
44,016
Location
New Zealand
Gender
Female
Country
New Zealand New Zealand
Unfortunately they knew immediately when they saw the xrays. The infection has already entered both my femur and tibia. They could see the changes to the bones on the X-ray.
@Mrs. Ciz - I'm sorry to read this has happened to you.

Are you taking antibiotics now?
It sounds to be as if you should already be receiving IV antibiotics, to start treating the infection in your bones.
 
OP
OP
M

Mrs. Ciz

member
Joined
Jul 24, 2020
Messages
219
Age
55
Gender
Female
Country
United States United States
@Celle
I am not on antibiotics yet. They will send the sample they collect during my explant on Thursday to an infectious disease specialist. He’ll do a culture to determine the best cocktail of antibiotics for my specific infection. My surgeon said if they give antibiotics now, they won’t be targeted to my infection and could change the infection sample making the specialist’s antibiotic cocktail less effective.
 

Celle

MODERATOR
Moderator
Joined
Nov 19, 2011
Messages
44,016
Location
New Zealand
Gender
Female
Country
New Zealand New Zealand
That makes sense.

So the date for your first stage revisions (the ex-plant) is Thursday, February 25, 2021 - is that right?
 

Cococay

member
Joined
Oct 21, 2020
Messages
241
Age
47
Gender
Female
Country
United States United States
That is just crazy to me,- I guess in my mind- I think infection and I picture and obvious open cut on the leg- and fever, chills, etc. I am really glad that the school nurse pushed you a little to get in. I am glad they are being aggressive in treating it. I cannot imagine how your feeling, but- you got this. Your in good hands, and all you can do now is trust in your surgeon and do whatever it is you feel you need to deal with this emotionally. Let yourself feel disappointed- knowing that it is all temporary. I will be watching your thread, and you have everyone on here to help support you and get you through this.
 
OP
OP
M

Mrs. Ciz

member
Joined
Jul 24, 2020
Messages
219
Age
55
Gender
Female
Country
United States United States
@Cococay
Thank you! I’m trying so hard to just accept it and plow through. It is out of my control at this point.

One thing I am super worried about though is the infection moving over to my good left knee implant. He didn’t X-ray the left leg because I’m not having any swelling or weird stuff in the left leg. But I’m terrified that the infection is lurking there too. It’s not swollen or red and has good range of motion. But the kneecap is tight/stiff. I don’t know what feelings are normal anymore.
 

PegGar16

FORUM ADVISOR
Forum Advisor
Joined
Nov 21, 2015
Messages
1,197
Age
60
Location
Phoenix, Arizona
Gender
Female
Country
United States United States
I know how frustrating and worrisome it is. For a couple of years after my final knee surgery I was constantly checked for infection if I had joint pains, not feeling well or off labs. I know they were a bit extreme but I appreciate it. I broke one of my fingers/knuckles last August and it ended up needing surgery. While in the preop signing the consents with the hand surgeon we came across the section on infection. He told me not to worry and I looked at him and stated I was part of the lucky 1%. He changed the antibiotic order..LOL. I really don't worry about it a lot any more but tend to be more attentive on what's going on with my body. Once you get your picc line the antibiotics will work its way through your whole system. They will take good care of you. Did you end up getting an infectious disease doctor?
 
OP
OP
M

Mrs. Ciz

member
Joined
Jul 24, 2020
Messages
219
Age
55
Gender
Female
Country
United States United States
@PegGar16
Yes, I will have an infectious disease doctor. I hear you about being in that “lucky” 1%. In January I got COVID and now this. This past weekend, my husband and I saw a billboard for the 22 million dollar Powerball lottery. I told him we needed to buy some tickets because my luck is so incredibly bad right now that it HAS to change soon! I’m due for some good luck!

I am paranoid about every little feeling in my good left leg now. I am so worried about the infection going there or already being there. The only strange feeling I get in the left knee is tightness in the front of the knee. I’ve never had that tightness in the infected right knee. Is it normal??? I don’t know what feelings are normal anymore.

Explant surgery is tomorrow. I’ll check in after that.
 

Jockette

SENIOR FORUM ADVISOR
Senior Forum Advisor
Joined
Aug 29, 2017
Messages
20,715
Age
65
Location
Delaware
Gender
Female
Country
United States United States
I am paranoid about every little feeling in my good left leg now. I am so worried
This is causing tension in your body, making everything feel worse. In my first year my knee always hurt more when I was upset about something.

And, at 7 months you still have lots of healing to do, even if you hadn’t gotten the infection.

I never had an infection, but I was “lucky enough” to be in the small percentage of people who didn‘t get a good outcome.

Sending best wishes, hugs and prayers.
 

PegGar16

FORUM ADVISOR
Forum Advisor
Joined
Nov 21, 2015
Messages
1,197
Age
60
Location
Phoenix, Arizona
Gender
Female
Country
United States United States
As Jockette states above that tension makes everything feel worse. I still get little tweeks in the knee on occasion but nothing bad and normally when I overdo some activity. For example recently I have taken up riding the bike around the neighborhood to work on some of this "COVID" weight, figure that's a good excuse for the weight gain :) It took a few trips to get the seat adjusted to the right height and to build up the strength in that leg. I had some aches and pains at first but I ride further now.......now I just have to adjust the diet..LOL.
I hope you get some reassurance with all the antibiotics they will have you on and that they will be monitoring everything.
Sending you prayers and good wishes and look forward to chatting after your surgery.
 
OP
OP
M

Mrs. Ciz

member
Joined
Jul 24, 2020
Messages
219
Age
55
Gender
Female
Country
United States United States
Had the CT scan with contrast this morning. I read the report in MyChart. Maybe I shouldn’t have. Extensive bone loss in the tibia sounds BAD! Here’s the report:


Findings: There is a right total knee arthroplasty. Streak artifact
from the knee arthroplasty degrades evaluation of the adjacent bones
and soft tissues. There is osteolysis surrounding the tibial component
and to a lesser degree the the femoral component. For reference, a
large region of bone loss adjacent to the anteromedial aspect of the
tibial tray, extending adjacent to the left aspect of the main peg and
surrounding the left peg spans approximately 26 mm x 19 mm x 28 mm.
There is cortical breakthrough along the anteromedial tibia with
adjacent periosteal reaction. There is adjacent soft tissue thickening
along the anteromedial aspect of the proximal tibia. There is a small
central focus of hypodensity within this region of thickened enhancing
soft tissue. Region of soft tissue thickening spans approximately 4.5
cm x 2.5 cm x 4 cm. There is overlying skin thickening and
subcutaneous fat stranding. There is synovitis in the knee. Bone loss
in the femur is seen most prominent along the anterior superolateral
margin of the femoral component.

Impression: Right total knee arthroplasty with extensive bone loss
adjacent to the tibial component and to a lesser degree the femoral
component. Findings are suspicious for arthroplasty infection.
Recommend correlation with arthrocentesis. There is anteromedial
tibial cortical breakthrough with adjacent periosteal reaction. There
is adjacent soft tissue thickening with central hypodensity,
suspicious for phlegmon, possibly developing abscess. There is
overlying skin thickening and subcutaneous fat stranding.
 
OP
OP
M

Mrs. Ciz

member
Joined
Jul 24, 2020
Messages
219
Age
55
Gender
Female
Country
United States United States
Out of surgery. Thigh really hurts! And my foot has fallen asleep in the right leg. Doing foot pumps to wake it up. The good news is that I got a dynamic spacer vs a static one, so I can bend my knee!!! And for the first time in a few months, my leg can straighten!!!

My husband talked to the doctor but I haven’t yet. He is under the impression that I can keep the dynamic spacer for years and not have a real knee replacement surgery done if I choose not too. I don’t think he heard this corrrectly!
 
OP
OP
M

Mrs. Ciz

member
Joined
Jul 24, 2020
Messages
219
Age
55
Gender
Female
Country
United States United States
Good morning! I had a pretty good night! Only had to get up to pee once vs 6 times last surgery. Having one good leg makes getting up and around so much easier! BTKR was truly a bear!!!!! My right leg hurts from thigh to ankle. Just got more Tylenol/Tramadol and will get oxy in a couple of hours.

Some good news- Dr was able to put in a dynamic cement spacer vs a static cement spacer is my right knee. That means I can bend my knee some and I don’t have to have my right leg immobilized. I can also straighten my leg for the first time in a couple of months!!! And I don’t have the agonizing behind the knee tight hamstring pain I was plagued with for months in my right knee last time. Silver linings for sure!!!

I’ll know more about the infection later today when I talk to my surgeon. My husband said there was not much pus, so we caught it before it went totally crazy. I have some extensive bone loss on the medial front side of tibia and some on the lateral back side of femur in back of my leg. That’s exactly where all the sore spots have been these last few weeks. I’m so relieved there was a reason for all I was feeling in my right leg, that it is getting resolved, and I’m not stuck with a bum knee. They also xrayed the left knee in recovery yesterday. Hoping and praying it looks totally normal because I’ve been paranoid all week about every little twinge in that leg since Wednesday’s infection diagnosis.

I’ll be in the hospital until probably Monday. I appreciate all the thoughts and prayers more than you know!
 

Jaycey

FORUM ADMINISTRATOR
Administrator
Joined
Jan 27, 2010
Messages
34,986
Location
Yorkshire
Gender
Female
Country
United Kingdom United Kingdom
@Mrs. Ciz Sounds like your surgery went very well. Good news about the spacer - much easier for you.

We are here for you! Rest up and stay ahead of the pain.
 

New

STEPS Challenge
Active Antibacterial

BoneSmart #1 Best Blog

Staff online

Members online

Forum statistics

Threads
54,791
Messages
1,428,662
BoneSmarties
33,979
Latest member
Miah1996
Recent bookmarks
0

Top Bottom