Knee Infection* LATE Chronic infection, 4 years after TKR

[beralc]

@csforrester99 What a journey you’re having!! Hopefully things will improve for you and you’ll steadily recover.
Not much consolation but what with one thing and another I haven’t started any outside PT and I'm 5 weeks on. I’ve had to have a lot rest and have barely done any consistent exercise. You can only deal with one thing at a time and getting you over this part, is what matters for now.

Sending you wishes for a speedy recovery.

 

[otto21]

I am so sorry you’re dealing with this!! What a nightmare when you just wanted to improve your quality of life getting a TKR. Unfortunately you will need an antibiotic so I pray they can find one that you can tolerate. The last thing you need to worry about is PT honestly. I had an infection and had a debridement and poly exchange then six weeks of iv ancef. I did next to no PT for six weeks because I was on home health and they were awful about coming for PT. Long story. Just try to keep doing exercises in the hospital bed even if you can’t do more.

 

[Layla]

Hello, csforrester,
Thinking of you and hoping you're resting comfortably.
Let us know how you're doing when you're feeling stronger and well rested.
Hugs
@csforrester99

 

[csforrester99]

I got out of the hospital 2/17, seven days in the hospital. The docs came to the conclusion I have DRESS Syndrome from the IV antibiotic vancomycin. The whole reaction, was quite frightening. They first indicated Steven Johnson Syndrome then switched to DRESS. Infectious Disease convinced me to test another antibiotic while under hospital care. Daptomycin. MISTAKE. I reacted to it too. I was pretty sick. I have upcoming appts with my primary, Dermatologist, ID, and allergy immunology. I am still rushing.

And, scary part is, I am not on any antibiotics. I did 3 weeks and 3 days on Ceftriaxone and Vancomycin. ID wanted 6 weeks of PICC and 6 weeks oral. I am scared to death to do any more antibiotics. DRESS affects your liver kidney and lungs.

it is risky to not do antibiotics either, infection in knee. They did put antibiotic in my cement.

This has been very scary.

My knee was in an immobilizer for 10 days. My post op Ortho appt was postponed 10 days, because I was in the hospital. So my outside PT started behind schedule. I have had 2 sessions-started last week. Back to normal this week, 3x. My ortho appt went good. Knee looked good. Bend at 90.

Friday, PT had me at 95° but that is 4.5 weeks. I work PT at home, and have since getting out of the immobilizer.

 

[Jamie]

Please don’t worry about your ROM right now. Your knee will be fine even if you have to delay therapy. Your first order of business is to deal with the infection and the problem of reactions to antibiotics. Be sure to ask plenty of questions of all your medical team so you’re sure they are on the right track.

 

[sistersinhim]

As Jamie said, there is no reason to worry about your bend, it'll come naturally. I was in an immobilizer on each of my knees for at least 6 weeks, and I was bending fine in a couple of months. The knees came back without any formal PT or exercises, I just used my knees normally doing my personal daily activities.

 

[csforrester99]

Thanks ya'll. Yes, I am very concerned about the rock and the hard place I am in, in regards to infection, and antibiotics. I looked up several case reviews regarding infusion timeline, oral timeline and outcomes of infection for no antibiotics vs 6 weeks, etc. It has been interesting. But, part of me thinks 3.5 weeks, plus antibiotics in my bone cement, has to count for something?

 

[Jamie]

Of course, the ability to have had some antibiotics does help. The problem would be if the infection has not been completely eliminated during that time. This is something you need to continually check on with your infectious disease doctor. They normally monitor the status of an infection, but in your case that’s going to be critical. So don’t be shy in insisting on reassurance that things are stable.

 

[Layla]

Hi csforrester,
Stopping by to say Hi on this two month, to date, anniversary of your latest surgery.
How have you been over the past three weeks? I hope you're doing well.
We do care and we're here if you need us.
@csforrester99

 

[kneed to know]

Sending you Compassionate Golden Light channeled from Kanzeon a Buddhist goddess of compassion.

 

[csforrester99]

Thanks @Layla. I am going into my 4th week of PT, 11 sessions to date. I was a month out on PT from surgery first 10 days was in an immbolizer then, off to the hospital for 7 days because of the IV antibiotic reaction.

PT is going ok. My knee is stiff and does hurt. I can't take anti-inflammatories to help with inflammation ...but, I caved an took a celebrex. Not supposed to, but I have to reduce the inflammation to rehab this knee, and it does help. But my PCP ordered labs after this DRESS Syndrome diagnosis, when I told him I just felt plain tired. They came back showing my kidneys were not working as they should. He said they were off from 2 weeks ago. And to stop Celebrex. It Showed my eGFR dropped 50 points in 2 weeks- not good. I haven't had kidney issues before. DRESS can damage your kidneys, after the fact. I went back in and repeated those labs, and they were back in the normal range, thank the Lord.

My ROM is 0-108, gaining a few with each session. My PT isn't concerned with my ROM, he said he'll get me there. But my knee does hurt.

My quad muscles are weak. And I have to pull up on the 6" step. That is the part i struggle with. But I definitely more stability than pre surgery. One BIG issue I have is my other knee, which was bone on bone back in 2020, it is wanted to buckle a bit and hurts.

As for the antibiotic situation, ID checks in with me often-weekly to see what I want to do about initiating 2 orals. I do not want to pursue this, given what I went through, and am still going through from the reaction. I have met with ID, PCP, Allergist/Immunologist and Dermatalogist. Has been a rough and crazy ride so far.

Wondering if I ever posted photos of the reaction across my body. Hmm ...?

 

[Layla]

Hi again,
Glad the labs in regard to your kidneys were within the normal range after a second blood draw. That's a relief.
It sounds like you're staying on top of things. Good to know. You did post the photos of the reaction. They are Post #17 in your thread, here, on the first page. My goodness...what a reaction!
May it only get better from here on out. Please keep us posted on your progress and have a good week.
@csforrester99

 

[csforrester99]

UPDATE: 4/8/25
UPDATE: Tkr 12/2020, revision 1/16/25, due to infection. Weight bearing knee immbolizer 10 days, hospital stay 5 days, picc line- Vancomycin IV and Ceftriaxone IV for 6 weeks. Only able to complete 3.5 weeks- due to severe deadly reaction to vancomycin sent to ER, in hosp 7 days, diagnosed with DRESS syndrome. Follow up labs- with immunologist, allergist, pcp, dermatologist, infectious disease. Placed on prefnisone for 1.5 months. Could not complete the antibiotic regime. ID wanted 6 weeks IV and 6 weeks oral. So, I am short 9 weeks of antibiotics. Vancomycin could have killed me.

ELEVENTH week- doing pretty good. 123/0 ROM, no pain, but do have some stiffness that comes and goes. No swelling. Working on quad/hamstring muscle strength. All in all, doing ok, given all that has transpired.

 

[benne68]

Thanks for the update, @csforrester99. Glad to read that you are doing well given what you've been through with that knee.

Hope you have a great week.

 

[sistersinhim]

Good to read that you are doing well now.