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TKR Infection Possible

Framatome

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I had my right TKR done September 4th. All is going well. Was moving along with PT and bending was good. Now having struggling with straightening.

3 weeks ago started to have a little increase in pain and weird symptoms that would come and go like early evening chills that went on for about a week. Then progressed to chills and generally just not feeling well over the next week with nausea. And now diarrhea and a general feeling not being well.

I went to see my surgeon who decided to take to blood test for inflammatory markers see if they were elevated as the knee is not red nor warm. That was a few days ago. Symptoms are still progressing and I'm sad and crying all the time. It almost feels like I have the flu but have no other flu symptoms. And after speaking with him on Friday, he did not think it was the flu or a virus either.

Saturday I felt so bad I couldn't get out of bed. I developed nausea and terrible diarrhea and miserable feeling. Called the office and got the on-call surgeon who told me he would speak with my surgeon and get back with me. He called me back later in the day to tell me that that both markers were elevated and they needed to do a knee aspiration immediately on Monday morning.

I've just not heard of a knee infection symptoms being this way it seems unusual. Any input anybody can provide would be helpful as stated symptoms have progressively gotten worse over and almost three week.
 
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Jamie

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Hi, Framatome.....so sorry to hear you're not feeling well. You did the right thing by getting to your surgeon quickly to have things checked out. Infections can result in a number of symptoms (or sometimes no symptoms) and the fact that your markers were elevated could point to this as a problem. The next step is exactly what your surgeon is doing - an aspiration - in order to rule infection out as a cause for the way you are feeling.

How does your wound look? Any redness, swelling or draining?

Please take things easy until you see the doctor again tomorrow. Let us know how things go.
 
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Framatome

Framatome

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The wound looks good. The knee is swollen but not warm and no redness. He said thst could be because its deeper into the joint. Have more pain and stiffness can't take any steps without walker. Physical therapy had started to become more painful and my numbers slipping backwards. My surgeon doesn't believe in hard Physical Therapy but gentle physical therapy. Hoping they have an answer tomorrow once they do the aspiration
 
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Framatome

Framatome

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2 weeks ago when my PT moved my kneecap around, I did have a little bit of yellow pussy looking oozing. But she said it was maybe coming from the scab that was near it. But then it oozed throughout the day a little bit and then I haven't noticed any oozing sense. However, I'm having pain down my shin in the past couple of days which is new. When I go to moved my knee from one position to another, I got a terrible shooting pain down the shin.
 
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sistersinhim

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I pray there's no infection in your knee, that it's just coming from overworking it. Shin pain is pretty normal. I know I had it and still am tender from the area where the stem goes in my bone down to my ankle.

To increase my extension, I walked with longer strides with a heel to toes stride. It didn't happen overnight, but my extension improved by doing this. Others have success just having their foot on an ottoman, letting the knee 'hang' on its own.
 
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Framatome

Framatome

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Thank you so much for your help with this. I also can't put weight on the leg hardly. If I try it is painful and just gives. If I even tried full weight bear would have pain and fall.
 

Jaycey

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@Framatome I hope you get some answers today at your appointment. Please do keep us updated.
 
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Framatome

Framatome

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They pushed it to tomorrow but it's only one day. Keeping my fingers crossed. Kind of concerned the aspiration is going to hurt!!
 

Jaycey

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They will use a local anaesthetic to numb the area before the aspiration. If you are at all concerned do mention this to your surgeon. Fingers crossed for you!
 
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Framatome

Framatome

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Oh that makes me feel so much better to hear that. Thank you so much. I was unaware that they would numb it first so I'm much better with that.
 
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Framatome

Framatome

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Had the aspiration today, oh my goodness it was extremely painful. He said it would take two weeks for whatever it is to grow if anything. He didn't think it was infected. I have however I got some initial test results this afternoon but I have no idea what they mean. I have attached the results. One of them the total nucleated seems extremely high to me but I have no idea what that really means
 

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Celle

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Most of the normal values are written underneath your results, @Framatome . However, I'm afraid that assessing fluid aspirations really isn't my area of expertise. That's much better left to your surgeon.
 
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Framatome

Framatome

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Thank you so much for all of your help. I really appreciate your input.
 
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Framatome

Framatome

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I am 3.5 wks post op and still cannot straighten knee. Physical therapist says I need MUA but I don't want to do that. They say I am at -15. My bend is at 110. During home therapy they would come in and I would be in pain and swollen for days not making any progress. I had two weeks off of home therapy before outpatient started and I started to feel better. I was able to get rid of walker and use a cane. Two weeks after starting outpatient they are again talking about MUA. I see the surgeon next week for follow up and am hoping he does not agree. Can I avoid this MUA? Will my leg eventually straighten?
 

Roy Gardiner

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You'll notice that I have merged your newest thread 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 start 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.
So please post any updates, questions or concerns about your recovery here.
 

Roy Gardiner

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This must be LTKR? Would you like to add the exact date to your signature, or post it here and a staff member will do it for you.

Physical therapist says I need MUA but I don't want to do that.
Quite right, far too early, by months.
Can I avoid this MUA? Will my leg eventually straighten?
Yes, yes :thumb:

See my ROM and extension exercises, linked from my sig below.
 

Jockette

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I agree with Roy, it is way too early to even talk about an MUA. And, those are done when your bend is not coming along, and yours is fine. An MUA doesn’t help straighten our leg.

Roy’s gentle stretches and just waking, will help your leg straighten over time, but it can take a long while, which is fine, so try to be patient.

Even if your surgeon recommends an MUA, you have the final say, and you have every right to decline. He can’t do it unless you sign a consent form.
Saying no to therapy - am I allowed to?
 

sistersinhim

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MUAs do not help with extension just bend. Your knee is still a baby and all it needs is walking and time. It is only 1/3 of the way healed and it's not unusual for extension to take longer to come in than the bend. Those tendons and muscles are long and take time to stretch out. Mine took a while to come in, but I had read here that it was OK. I helped mine improve by walking with long strides, heel to toe. If you do this, make sure there's something to grab hold to in case you lose your balance. It won't happen overnight, but will get better.

Please give your knee more time and don't fall for anyone's false statements that there is a time restraint on your extension improving. There isn't.
 

Celle

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@Framatome - I'm sorry you're still having problems with your knee.
But they aren't as bad as your therapist would have you believe.

Remember that your knee had a little set-back in the early days, when there was a possible infection? Well, that will have stalled your progress for a while, so allowances should be made for that.

You didn't tell us, but i'm assuming that your surgeon found you didn't have an infection. Is that right? If so, that's great.
 

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