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Revision TKR Lovetocookandsew’s long road to recovery

Celle is right, the infectious disease dr will know exactly which antibiotics to use on what infection. The procedure you'll be having is what I had done, multiple cultures were taken and I had a visit from the infectious disease dr the very next day (Thanksgiving Day). It did take at least 3-4 days for some of the cultures to grow. But I was put on IV antibiotics immediately.

Is your washout scheduled yet?
 
@KarriB . Thanks! It's not scheduled yet, but I expect a call from his assistant as to when. Was your infection soon after the TKR, or long after? It's been almost 2 years since my TKR. My OS wants to wait on antibiotics and the ID doc until we have culture results, maybe due to the fact it's nearly two years out?
 
I just received the LTT results. Okay, I was wrong....it came up quite reactive to nickel. The original one didn't and I think it was because that test was done using our lab's tubes as the kit's tubes were expired, plus it was a summer kit they shipped to the lab in Chicago instead of the winter kit. This one was done following all the protocols exactly. Oh, I also had a mild reaction to bone cement, which may not mean anything, or may-I am clueless about all this.
 
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My infection was one month after the original TKR. I experienced a high fever and seeping from a closed incision. Does the nickel info mean you'll need a specialized implant?
 
@KarriB . I'm not sure exactly what this all means as I don't really understand it all, but I did e-mail my OS with a copy, even though I'm sure he has a copy already, and I asked him what this means overall.
 
I know there are some implants that are nickel free. Maybe it's the reaction to nickel and not an infection. I hope you have your answers soon from your email.
 
@Josephine I didn't want to hijack someone else's thread in regards to keloids, so moved over here. Hmmmmmmmmm..............well, since I am having either a clean-out and spacer change in the near future, (unless my OS decides the recent LTT metal allergy result says I need a revision, plus I possibly have an infection in there) maybe my OS (long story, but this is my original OS, not the one who did the TKR) can reduce or get rid of the keloid altogether. What's your opinion?
 
I received an email form my OS this evening. He says, in response to my asking if the LTT result changes anything, "I don't think so. Only reacted to the higher concentration of nickel. Would hate to take everything out and put in new knee with less nickel and find out problem is infection."

So, we're going to do the clean-out and spacer replacement with cultures of fluid, tissue, etc, and go from there. I was wondering myself, if we went on the assumption it was an allergy to metal, and he replaced the joint, then later found out there was an infection in there, what then, so this seems the wiser course in the long run. I told him I don't want a revision unless it's the only option, if there's anything else to try, that's what I want.
 
I hope your problems can be handled by the washout and change of the spacer. You have decided on your plan of action. I hope all goes well with it.
 
lovetocookandsew said:
maybe my OS can reduce or get rid of the keloid altogether. What's your opinion?
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Well, considering he will most likely use the same incision - as they invariably do - that would certainly be a yes. They generally excise the old scar anyway as a matter of course.
lovetocookandsew said:
Would hate to take everything out and put in new knee with less nickel and find out problem is infection."
Click to expand...
I think that sounds entirely reasonable.
 
Thanks, @Josephine I kind of assumed he'd end up getting rid of the keloid, as he will be going right through the old incision, but forgot to ask him that when he told me what he was going to do. I am in agreement with him as to the process, I'd also hate to assume it was a nickel allergy causing the problem, etc. etc. It's just such a pain overall; I am almost back where I started with pain, swelling, inability to do stuff....I had thought the TKR would give me back my life and it did for a few months, then everything went kablooey.
 
It's so nice to have a visit from a brand new grandchild along with his big sister! Sure helps with my mood lately. It is a pain going through all this again, but spending time with a sunny 6 year old lifts any sour mood! The birth of this grandson makes 10 grandchildren total. Wow. Seems like only yesterday my own were little and now some of my grandchildren are adults themselves. They range in age from 20 down to 3 weeks old. I don't feel old enough to have adult grandchildren...lol. I have been reading through some of the infection and revision threads and have picked up some needed info and advice, so thanks all! While I don't yet know if I have an infection, a reaction to the nickel, or something else going on, I am grateful for a good OS who is willing to do what's best for me even when I'm a pain to deal with.....haha. Poor guy..... I'm just waiting for a call from his scheduler with a surgery date for the clean-out, liner exchange and cultures to see if we get any answers. While my synovial fluid was cloudy, we didn't get any other answers due to a lab screw-up, so I am hoping this surgery will give some answers and my knee will begin to heal. I'm still not sure about the recovery on this, the time I'll need to be in the hospital (hopefully just a couple of days to get me recovered enough from the procedure and on to oral pain meds), if I'll be able to walk right away or use a crutch, etc. I had so many questions at my last visit that I didn't remember everything. He did tell me that the pain and recovery from this won't be as easy as the scar clean-up in October, nor as difficult as the original TKR, but I really don't know how I'll feel, etc. I'm one of those who likes as many details as possible going in so as to be more able to plan and prepare-both mentally and realistically. Oh, he's also doing my left carpal tunnel surgery at the same time since I'm a big baby and refuse to let him do it in his office while awake...I really am a pain for him aren't I...rofl.
 
Wow 10 grandchildren! What blessings they are. When I went to have my last meeting with my OS before I have my revision planned for the 21st I brought a list of written questions with me. I also had my pen in hand in case I needed to make any notes. You might want to formulate a list of questions to ask and then send an email with them all or bring them with you if you have another office visit planned before your surgery. I also like to know everything before hand so I had a pretty long list that either my surgeon or his PA answered for me before I left the office.
 
Thanks @newlybionic I actually have a brand new Samsung note phone, so wrote all my questions directly on it, then made notes on it also as we went. But still I had questions after-I'll probably keep thinking of things as time goes on. If you, or anyone else, have any suggestions as to good questions, I'd love to hear them, plus any info on your experiences. I'm not kidding about my needing to know every teensy tiny detail-it really seems to help me prepare myself. I like to know going in how long the surgery will take (I know it shouldn't matter as I'll be asleep the whole time anyway), how many days I'll have to stay, even though we never know due to my strange body and all it's crazy reactions, but I like to know likely scenarios anyway, how much pain I'm likely to have, how exactly they treat you with antibiotics if they find an infection as my OS seems to suspect I have, what the EXACT procedure is, are they oral or IV, how that works if it's long term, etc etc. I know I'm a pain but that's how my brain seems to work. Oh, and I actually did send an email to him with a couple of questions I forgot when I saw him.....poor guy to have to put up with me........I'll be thinking of you on the 21st and will look forward to hearing how you do and how you recover.
 
@Celle I hope you're right, I just can't help feeling I'm getting annoying with all my questions and the time it's taking to get this resolved............
 
@Josephine As you may have seen, I'm having a clean-out and liner exchange soon. I was reading through your surgery threads again, and noticed you did no exercise this time around. I'm not sure what the recovery will be like for this procedure, but am wondering if you know if they generally prescribe PT, and if they do, does the same thing apply here? Or do you recommend PT here? Or...? My OS did tell me the recovery will be harder than the scar tissue clean-up I had, but not as difficult as the original TKR, which gives me a few clues, but not many. I have asked him a ton of questions, and missed a bunch too. I followed your gentle exercise advice after the TKR, but now I see you've changed that to no exercise, so am wondering what you think. Thank-you.
 
After my antibiotic washout/spacer exchange I was not allowed to bend and wore an imbolizer. My OS felt the soft tissue was extremely compromised by the two surgeries, washout (I think they used a brush) and infection. The first day I stayed in bed but the second day and first get up was painful, I remember crying because my dad called as they were getting me up. I answered the phone because I didn't want him to worry, but he did worry because I was crying. But after that the pain wasn't nearly as bad as the original TKR. Plus I could only do stretches and exercises that kept my knee straight.
Hope this helps you a bit. Do you have a date yet?
 
@KarriB Thank-you so much. It is very helpful. How long was it before you got the immobilizer off and could bend your knee? Did you have to use crutches, a walker or a cane? I don't have a date yet, but expect to hear from his scheduler soon. I'll post the date as soon as I know it. I am totally dreading this, but really hoping it works. I'm having a few bad dreams already about it, so I know my whole body is dreading it.
 
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