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

[Mrs. Ciz]

Well I survived my first two days back at work (teaching middle school face to face). Monday I had admin time most of the day because I’m also the Dean of Faculty at my little school. I used the time to organize my temporary classroom in the 1st floor cafeteria. Some 8th graders helped me carry all my materials from my 3rd floor classroom to the 1st floor. I went to the 2nd floor more times than I wanted to because I needed to make copies and get stuff from the school office. I was pooped when I got home. My Fitbit went off during dinner when I reached 8889 steps - way more than I was planning! I also had my 2nd to last PT appointment that morning.

I was already sore when I went to work on Monday because while I only walked 4900 steps on Sunday, I dusted my house, which required a lot of bending down to reach the low places. All the bending made my right hamstrings really act up. I hate that pain!!!! I didn’t sleep well because of it. Behind my knee hurt all day Monday, and I was so sore by Monday night that even my hips hurt! I spent the whole evening alternating between ice packs and the heating pad.

Today I had classes all day, so I stayed in one room for the most part and got up sit on the wall during recess duty. I am way less sore today. Even so, I’m at 7200 steps. I think I’m going to drop into bed at 8:00 pm tonight!!!

Tomorrow morning I have my last PT session. I’m going to miss those knee massages!

 

[oregonlass]

@Mrs. Ciz - It sounds like you were in the same place I came from with your knee with no cartilage. However, my problem was only with one knee.

I had sciatica before surgery from the poor alignment. Two months PT pre-surgery got that under control. I noticed yesterday, someone also said the Achilles tendon and sciatica nerve chain are side by side so pain can be easily confused. I'm doing stretches for both, getting my walks in, elevating in the evening. I use cold for swelling of the knee and warmth to get the muscles relaxed. I did stop any knee resistance exercises that made the pain worse.

 

[leejaa]

Glad to read that you are planning on early bed and rest. It is hard to return to work after being away but with recovery added it does make it very tiring. Keep listening to your body and your knee. I hope it gets easier soon.

 

[Mrs. Ciz]

Last day of PT was today. I’m kind of sad because when I got there at 7:00 am, my right leg was so bent and stuck that I was limping. After my therapist did his manipulations (stretches and massage) and I did some exercises, I was loosened up and could walk normally again. I’m going to miss his help!!!

I can’t believe how far I’ve come in 12.5 weeks. Today at school I was able to practice going down stairs normally. The stairs in one part of our building are shallow/have a shorter rise than regular stairs, so I gripped both railings and gave it a go. I did it!!! I’m going to practice on that staircase everyday until I can do it without thinking about it.

On a completely different note, after reading here about so many people needing revisions or getting infections, I wondered what type of TKR surgery everyone had and what their surgeon’s infection protocols were.

I had MAKO Robotic Arm assisted surgery. I had to get CT scans done on both knees the week before surgery, so the robot could map out the surgery in advance to make everything fit perfectly. I just watched a YouTube video about it this afternoon. It was pretty cool!

The infection protocol at my hospital was intense. I had to get my nose swabbed for MRSA and MSSA (less serious). I was positive for MSSA, so I had to put prescription antibiotic ointment in my nose for 5 days presurgery. I also had to change my sheets 5 days before surgery and shower with a special antibacterial soap for 5 days presurgery. The night before surgery I had to change the sheets again shower before bed and then shower again the morning of surgery with the special soap. In pre-op, during surgery, and for 24 hours after surgery, I got IV antibiotics. My incisions were covered with waterproof bandages. I had an appointment with the surgeon’s PA to get the bandages and staples removed 1.5 weeks later. He then cleaned the incision sites and re-bandages them. I was not allowed to remove them until everything was scabbed over.

I’m curious about what other folks experienced.

 

[Geoffa]

Your infection protocol was similar to mine here in Canberra Australia.

 

[Fran55]

How was your first week back @Mrs. Ciz ???

 

[Oregon mom]

I gripped both railings and gave it a go. I did it!!! I’m going to practice on that staircase everyday until I can do it without thinking about it.

Congratulations on the stairs! That's wonderful! I've gone down the stairs facing forward only a couple of times, and it was pretty comical. It took forever and each movement was a big drawn-out effort. My muscles were clearly confused, since I've been going downstairs backwards for almost a year now.
I'm so excited for your progress and graduating from PT (even though you loved it, that's an accomplishment!)

 

[oregonlass]

Infection control similar but different. They put everyone on the nose ointment as a precaution. Covid test 3 days before and quarantine until surgery. Pre-op guidelines were the same as yours. Showers with disinfecting soap 4 days in advance. Fresh bed linens and sleepwear. Dec of 18 for my hip it was just a shower the night before and the morning of. So they have gotten much more aggressive. The big concern as you stated was MRSA type infections.
My doc works with two assistants, non-robotic. I know they used cauterization during surgery. No staples or removable stitches. I didn't ask what was inside. The after bandaging was a 2" wide steri-strip the full length of my incision, waterproof webbing over that and bandages over that. Post-op 2 weeks they removed the outside bandage and web mesh leaving the steri strip in place. That came off pretty much by itself at about 4.5 weeks. The incision has sloughed the tiny bits of remaining scabs. Doc puts everyone on low-dose aspirin therapy and compression stockings for 6 weeks post-op.
They did recommend a flu shot which I did a couple of weeks ago.
Since the covid numbers are rising, we have been very careful about going out and still using an online grocery order and pickup service. Produce can be a bit iffier, but not ready to try the farmer's market until the virus numbers drop. They are threatening my county with a return to Phase 1 if people don't stop having private parties or social gatherings and causing the spread of the virus.

 

[Muldoh]

Just read your recent posts Ms. Ciz and it sounds like you’re doing really well Back at work, 7200 steps and going down stairs like a regular person!! That’s an amazing feat considering you had bilateral TKR! I am back to work next week and crossing my fingers I can do well too. But I’m way too chicken to try to go down those stairs

 

[Mrs. Ciz]

@Muldoh
I didn’t go down the whole flight normally; I just did about 5 stairs to see if I could do it. I could! But it was slow and slightly uncomfortable, and I needed the hand railings, so I’m going to need more practice and for my knees to relax some more before I can do the whole flight of stairs. I’m going to practice every day I’m at work!

 

[Mrs. Ciz]

How was your first week back @Mrs. Ciz ???

It was fun and exhausting! I am NOT a morning person and have not had to get up early for the past 7 months, so the 5:40 am alarm was pretty brutal, especially since I’m still waking up a few times a night. I will say that my sleep is getting better at night because I’m just so dang tired when I get into bed. The first couple of nights, I went to bed at 10:00 pm. By the 3rd and subsequent nights, I was in bed by 8:30 pm.

Work wise, it has been pretty easy thus far because I prepped so many lessons for my sub (way more than she needed) just in case something went wrong, and I had to be out longer than planned. That worked out great for me because when I went back, my lessons for the next 3 weeks were already prepared and photocopies were made.

I am probably walking too much on most days. I think the first day I was over 9200 steps. The other days I really tried to watch it but still ended up with 8000 to 8500 steps. By the end of the school day, I was sore. My class schedule makes it hard for me to ice and elevate during the day. I’ve had a hard time even putting my feet up during class because I keep having to get up to write notes on the board or help students. But once I get home, I’m on the couch with my ice packs until dinner time.

The best part of going back to work has been spending time with my students and my coworkers - even if we are all masked up and socially distanced!

 

[Fran55]

The best part of going back to work has been spending time with my students and my coworkers - even if we are all masked up and socially distanced!

I am sure this WAS the best. part @Mrs. Ciz!

Hopefully things will continue to improve for you as you settle back in.

 

[Mrs. Ciz]

I just finished my second week back at work. And honestly, I feel like my ROM is now regressing - especially the extension in my right knee. It’s like it’s spending too much time bent (sleeping on my side with it bent, sitting in a chair with it bent) that now it wants to stay bent, and that’s making me limp really badly.

I’ve had tight hamstring issues that cause behind the knee pain in the right leg since the beginning. The left leg is so much further along; however, today I noticed that the left knee feels much tighter in the front than the right knee does. Weird. I am trying to take it easier at work. Usually I walk between 5000 and 8000 steps a day, and I’ve been trying to avoid multiple trips up and down the stairs when I’m at work, so I don’t overdo it.

Today I did a bunch hamstring and calf stretches during the day while sitting in my desk chair. That help unbend it somewhat. I finished 12 weeks of PT last week, so now I’m on my own. My therapist gave me a list of exercises to do, but I’m sore and exhausted when I get home from work. I ice and elevate for an hour or two, eat dinner and then go to bed by 8:00/8:30. I go to bed so early because I still wake up multiple times a night (last night it was 9 times awake, 21 times restless according to my Fitbit). I haven’t done any of my exercises since PT ended with the exception of the stretches I did throughout the day today. I’m thinking this may be why my right leg is getting all bent.

Should I still be doing all my exercises at this point (14 weeks post op)?

 

[newlybionic]

Now that you are back at work you can stop PT. You’re are getting enough exercise on your job. I would ice your knee when you go to bed and take some pain medication if you have it or at least take Tylenol. You might be able to sleep better.

 

[Mrs. Ciz]

My doctor cut off the pain meds at 6 weeks. It’s so not fair because there are days when I still need them. However, I do take Advil and extra strength Tylenol every 6 hours around the clock. It does help some. I can sure tell if I’m late taking a dose! I also ice for several hours before bed.

 

[Fran55]

@Mrs. Ciz you poor thing. At 5 months I still need a very occasional strong painkiller. The night before last was one of them. I haven’t been able to do much walking this week as I have had a lot on. My knees feel the best when I walk even if I do feel tired afterwards. My knees miss it when I don’t do it. My GP actually gave me another script for Tramadol last week as even though she tells me I am doing very well she believes me when I say the odd day still requires a dose.
I still do some stretching exercises sometimes particularly if I have had to sit for a while without my legs elevated. It seems to get my knees moving a bit better.
I cannot imagine the pain you must be having after returning to work. As a retired teacher I CAN imagine all the “exercise” you get through the day!! Teachers never stop. It’s exhausting without being in recovery from a Bilateral TKR!

 

[sistersinhim]

just finished my second week back at work. And honestly, I feel like my ROM is now regressing - especially the extension in my right knee.

It is not unusual for knees to swell and be painful after starting back to work. I'm sure this is what you are experiencing. Spend all your free time icing and elevating. Your knees need TLC, especially now.

 

[Mrs. Ciz]

@Fran55
By the end of my 2nd week back at work, I finally got wise and realized I needed to stretch while sitting in my chair before I got up and tried to walk. It made a pretty big difference! I’m going to stretch before I get out of bed in the morning and continue stretching when I’m sitting at my desk for long periods of time. It’s just really frustrating to feel like I’m backsliding.

I miss the recumbent bike at my PT clinic. Riding for 10 minutes really loosened up my legs. I can’t ride my regular bike yet (tried a couple of weeks ago), so I’m buying a bike trainer this week. I’ll pedal as far as I can go forward and backward until I have enough ROM to go all the way around. I am going to get back to riding my bike! It’s one of my biggest goals (that and going down stairs)!

 

[leejaa]

Can you get a small stool and extend your knee with ice while working. When I returned to work I would put a pillow over the garbage can at work under my desk and keep my leg extended for extended periods of time with ice packs on it. It helped some to change positions.

Returning to work is mentally and physically tiring so like you I would crash when I got home. I did not have the energy to do much more than that. It did get better but like everything else in recovery it took time. Keep being kind to yourself.

The biking is a great idea as is stretching out a bit before moving.

 

[Mrs. Ciz]

Today I am feeling super proud of my 85 year old mama but a little sorry for myself. My mom had her left knee replaced at 80 years old and did very well with her recovery. Shortly afterwards though she developed congestive heart failure and stage 4 kidney failure, which postponed her second knee replacement for 5 years. She finally stabilized, was cleared for surgery and had her right TKR on Monday. She left the hospital with flexion of 70. Just 5 days later on Friday she got to 103!!!! I am so happy with how well she is doing!!! It took me 12 weeks to get to 100 on my right knee and 110 on my left. I don’t feel like I’ve improved any since then, and I’m feeling a little discouraged.