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[KNEE INFECTION] Revision after infection questions

Discussion in 'Knee Replacement Recovery Area' started by pboedeker, Nov 16, 2017.

  1. pboedeker

    pboedeker junior member
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    I’m 7 weeks post revision for left knee with a nasty strep infection. I am allowed 10% weight bearing and just completed 6 weeks of PICC line antibiotic treatment. I will have another knee aspiration in one week to check for any infection that might remain. If clear, I will have another surgery the following week to remove the cement spacers and replace with a new knee.

    I’m curious what other folks success rate was for clearing infection in similar situation. I’m worried sick the infection might recur or worse yet, not show as cleared next week.

    I’ve had multiple surgeries on this knee since I was a child, it’s growth was somewhat deformed and along with the original TKR in March 2017, the surgeon also removed previous hardware and straightened the leg.

    Any and all info would be appreciated!
     
  2. SusieShoes

    SusieShoes FORUM ADVISOR Forum Advisor

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    Hello, @pboedeker, and :welome: to BoneSmart. We’re glad you found our community and hope we can help and support you. Having a knee infection is a serious complication, but one we see. I’m just so sorry you are dealing with it. People who have been there can give you practical, on point advice. Your knee has a complicated history, too, I see.

    I’ll tag our Nurse Director, @Josephine, who has years of orthopedic experience, and some of our staff who have dealt with your situation, @newlybionic and @KarriB.

    You can also visit the threads of other members who have dealt with knee infection, to see if they had revision and what their experiences were. To sort for the Knee Infection threads, just click on the red Knee Infection button at the top of your thread. That will bring up a list of all threads with that sub-heading.

    I’ll also give you our guidelines for recovery, which we give to all new members. The links are to short articles and may help you.

    Knee Recovery: The Guidelines

    1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
    2. Control discomfort:
    rest
    elevate
    ice
    take your pain meds by prescription schedule (not when pain starts!)
    don't overwork.
    3. Do what you want to do BUT
    a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
    b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​
    4. PT or exercise can be useful BUT take note of these
    5. At week 4 and after you should follow this

    The Recovery articles:
    The importance of managing pain after a TKR and the pain chart
    Swollen and stiff knee: what causes it?

    Energy drain for TKRs

    Elevation is the key

    Ice to control pain and swelling

    Heel slides and how to do them properly

    Chart representation of TKR recovery

    Healing: how long does it take?

    Post op blues is a reality - be prepared for it
    Sleep deprivation is pretty much inevitable - but what causes it?

    There are also some cautionary articles here
    Myth busting: no pain, no gain
    Myth busting: the "window of opportunity" in TKR
    Myth busting: on getting addicted to pain meds


    We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery. While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.
     
  3. Celle

    Celle FORUM ADVISOR Forum Advisor

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    Hello @phoedeker - and :welome:

    I'm sorry to hear you had the bad luck to develop a knee infection.

    Please will you tell us the dates of your original knee replacement and the antibiotic space insertion, and also all your major knee surgeries, so we can make a signature for you? Thank you.:flwrysmile:
     
  4. Josephine

    Josephine FORUM ADMIN, DIRECTOR Administrator

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    Yes, dates please. Plus you've given us such scant information it's a little difficult to advise you.

    One thing you can do is go into the Knee Recovery Forum and find any thread with this prefix infection knee.JPG , click on it and you will get the entire list of all threads which you can then read!
     
  5. pboedeker

    pboedeker junior member
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    More info:

    My initial surgery on left knee was in 1973 to shorten a ‘too long’ mcl. 1989 saw my first scope to help with horrible grinding. 2001 second scope to debride knee. Mar. 21, 2017 left knee, TKR. Over zealous PT (Apr. 19) on some apparatus supposedly helping with flex, unable to bear weight 24 hours later. Halted PT for three weeks. May 12, 2017 another scope for painful left knee patellar clunk. Spent summer getting no where with PT. Swelling, pain, warm, ROM getting worse. Diagnosed with aspiration Sept. 18th. Sept. 27, 2017 revision surgery for infection. Nov. 8, six week antibiotics course ended. Set for another aspiration Nov. 22.
     
  6. Pumpkln

    Pumpkln FORUM ADVISOR Forum Advisor

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    I added your surgery dates, if there is an error let us know.
     
  7. pboedeker

    pboedeker junior member
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    I’ve noticed the past 10 days a little warmth in the knee, but this appears to be in relation to when I stopped all Tylenol that I was using for pain. Think the warmth is inflammation related or could it be infection brewing again ?

    Perhaps I should try Tylenol for a few days and see how knee responds?
     
  8. Celle

    Celle FORUM ADVISOR Forum Advisor

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    It is normal for a healing knee to feel warm, for almost a year sometimes. It's a sign that healing is going on under the surface. Just note if it gets really hot or if you start running a fever. If you're concerned, though, do go and see your surgeon.
     
  9. KarriB

    KarriB FORUM ADVISOR Forum Advisor

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    My knee was warm for a while after the infection was cleared up. Although I didn’t have the TKR removed and an antibiotic spacer placed, I did have a washout/debridement/spacer exchange a month after my TKR. It took another month for the infection to totally clear with 6 weeks of a PICC line antibiotic and oral antibiotic. Even though my OS had my leg in an immbolizer for the first month after the infection with time I was able to achieve a good ROM.

    Let us know how your aspiration goes. Infection is a long haul but many have successful outcomes.
     
  10. pboedeker

    pboedeker junior member
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    Thanks all! I’m so anxious for aspiration results, but we have gone ahead and scheduled my next surgery, Nov. 28th.
     
  11. Bikesouth

    Bikesouth senior

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    Can you tell us what type staph & antibiotics?
     
  12. pboedeker

    pboedeker junior member
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    My infection was a strep version and my antibiotic for picc was rocephrin.
     
  13. newlybionic

    newlybionic FORUM ADVISOR Forum Advisor

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    I had a MRSA infection. I had 6 weeks of Vancomycin followed by 4.5 months of an oral antibiotic. I didn’t have a spacer placed. I had a washout with antibiotics placed in my knee. As of now I am infection free.
     
  14. pboedeker

    pboedeker junior member
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    I’m feeling more positive today about my knee. I feel so much better physically now and I’m hoping that translates to no infection on Wednesday’s aspiration.

    For those that had spacers removed and a new knee implanted, how did that surgery compare to your original implant surgery?
     
  15. pboedeker

    pboedeker junior member
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    Anybody have knowledge of these results?

    Aspiration done and waiting for doctor to call with results!

    A6386D2B-D7FD-4351-BE6F-BBFF401FC27C.jpeg
     
    Last edited: Nov 22, 2017
  16. KarriB

    KarriB FORUM ADVISOR Forum Advisor

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  17. pboedeker

    pboedeker junior member
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    Knee feels and looks a bit swollen today. Feels really tight when I try to bend it when off brace. Could this be a side effect of yesterday’s aspiration?
     
  18. KarriB

    KarriB FORUM ADVISOR Forum Advisor

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    It could be a little sore from that, but I wasn’t allowed to bend my knee at all for 4 weeks after infection surgery. But I don’t believe spacers are built for achieving ROM. I wouldn’t worry too much about it until you get the new TKR.
     
  19. Josephine

    Josephine FORUM ADMIN, DIRECTOR Administrator

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    Leukocytes, lymphocytes and erythrocytes are all flagged as higher than normal and all indicate some form of inflammation but it doesn't say what kind. This can actually be just from healing or therapy.
     
  20. pboedeker

    pboedeker junior member
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    Infection is CLEAR! Surgery in the morning to remove spacers and replace with new knee!
     
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