Knee Infection Infection post TKR

[Donnam]

@Josephine and @RestAssured - Thank you ladies for entertaining my questions...you can see I've got a learning curve to get through

Are you saying that infections show up relatively early (5 days to 5 weeks) and then it's just a matter of time whether it's more serious (ie Biofolm). What is the time frame for this? Will it not appear until after you are off all IV and oral antibiotics? If so what is the range of months/years to be on the look out?

And finally is there any type of tests to definitely determine if you are infection free? They take blood tests every week but i believe this is just an indicator of the inflammation/infection, not 100%.

 

[Josephine]

Are you saying that infections show up relatively early (5 days to 5 weeks) and then it's just a matter of time whether it's more serious (ie Biofolm).

No, you've got it mixed up. These two infections are nothing to do with one another. Completely separate and from two completely different sources.

 

[RestAssured]

Well....

The blood tests they would be using for inflammation would be CRP or C- Reactive Protein, and SED rate. Both of them should be under 20 in normal situations; although a higher number might be attributed to something else. The next thing they might do if these numbers are high, would be a 3 phase bone scan. Don't expect that for a little while though, because that is when they think the infection has attached itself to the metal. My scan of my right knee glowed. I don't know where I put it or I would post a normal left replaced knee vs an infected right replaced knee. It was very obvious.

 

[skigirl]

I am so glad that you are helping your dad with this whole problem. Infection is serious and complicated. It is good that you are acquiring information to help him.

 

[RestAssured]

@Donnam,

I went back to The Story of My Knees Part 1 for answers to your questions,

I had a lot of pain before it split open after 3 weeks, not 2. The thread goes on to mention pain after the washout and debridement, and spacer replacement. I really think that if you want an idea of what to compare your Dad's to, type The Story of My Knees Part 1 in search bar, and then my user name, and you will find out that your dad is doing pretty good!
When does he see the OS?

 

[Donnam]

Happy New Year! I wanted to provide an update on my dad’s situation and the recent doctors appointments..

We saw the OS and he took fluid from his swollen knee. He felt the fluid “looked good”, but sent it out for culture. He also shared the swollen knee was most likely due to his recent activity now that he can bend the knee. We should know the results from the culture on Monday.

We then saw the ID doctor and they took him off the IV antibiotics (it’s been 7 weeks). He is now on Cefadroxil (Duricef) oral antibiotics. The plan is to keep him on this for a year. Then take him off and monitor if the infection returns.

Here’s the interesting part – the OS talks about needing to do the 2 surgery revision if the infection returns but the ID doctor shared that they rarely see revision surgeries for knee infections. Instead they supress the infection with lifetime antibiotics. I imagine there’s quite a difference in opinions on this topic….thoughts?

 

[skigirl]

Right now the entire area of Knee infections is changing as different ideas and theories arise. It is an area that needs more research. If you have doubts in this treatment, it is always helpful and advisable to get a second opinion.

 

[RestAssured]

I would seek out a revisionist for a second opinion. I am on Bactrim for at least 5 more years. The ID doctor has cut it from two times a day down to one, but getting the revision is what has enabled me to return to living. Your dad is still very early in this fight; the difference between MRSA and Staph Aureus is that mine is resistant to Methacilan thus the name Methacillin Resistant Staph Aureus, or MRSA.

 

[Donnam]

@RestAssured - prior to the revision can you remind me what your issues were? Pain? My dad had no pain and is starting to regain strength (but very underweight) from the ordeal). He's starting to walk pretty decently as well. I just can't imagine how he will do having 2 more surgeries (if needed) at 80 years old.


Sent from my iPhone using BoneSmart Forum

 

[Jamie]

Please try not to worry about s 2-stage revision right now. Certainly it would be a possibility IF the infection came back and IF your surgeon determined that was necessary to get rid of it completely. But that is a lot of "ifs." I know it's difficult not to worry about your father. But you'll be a better supporter for him if you just try to take things one day or a few weeks at at time. It's still possible this will work and he will be fine. It's not always a given that a revision must be done. When they are done, they are not always a two-stage procedure. There are just a lot of variables where infection is concerned and you'll make yourself crazy trying to sort and worry about them all. He's making good progress right now and I'm happy to hear that!

 

[RestAssured]

@Donnam,

Prior to the revision, my replacement came loose. Your Dad sounds like he is making great strides though, so focus on his healing. They are watching him with the blood tests, and they will know if infection starts up again.

Then you can worry about a revision. Right now, just be there for your dad.

 

[melsie01]

Hello I'm getting ready to have stage 1 of 2 knee revision. This will be surgery #3 since Sept 2017. My question is, I keep reading about IV antibiotics. Does this mean weekly trips to Dr or you are sent home with an IV?

My 1st TKR was Sept then Feb Dr said I needed quadriceps tear surgery. Now new Dr states I have deep bone infection. Had bone scan last week. I have new Dr because the last one lost his license due to infections control and lots other problemss. I did not even need the 2nd surgery. I had all the signs of infection yet surgeon only did CT, never blood work, even though I had high fever, chills, fatigue , you name it. So been a very long battle for me and I'm only half way through.

 

[Celle]

@melsie01 - This is an old thread that you have resurrected. Your own thread is here:
https://bonesmart.org/forum/threads/2-stage-revision.47374/
It's called 2 Stage Revision it has a red "Knee Infection" prefix.
I created it for you yesterday, by combining your three threads from the Knee Replacement Pre-Op Area.
I tagged you, so you would see it. Do you understand what tagging is? Because you haven't responded, but have posted here instead.
How to tag another member; how to answer when someone tags you

I'm going to copy your post, above, into your own thread, and talk to you about it there.
Please post your questions in your own thread.