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[KNEE INFECTION] Revision with infection

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LolaBee

LolaBee

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Had a great first outpatient PT visit. Therapist is very nice and takes a slow, conservative approach to knee Rehab.
My swelling is quite bad, so that will slow me down some until its better.
I was shocked when he measured 92° bend !!
(Of course, I was worrying about it for nothing!).

I go twice a week for 25 allowed visits.
 

Celle

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I'm glad you have a PT therapist who is prepared to go at a pace your new knee can handle.
 
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LolaBee

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Me, too.
When I told him my hip, outer calf, and foot bothered me, he did some chiropractic-like adjustments. Felt relief right away. He explained in detail the structures involved, why they hurt, and why he used each technique.

Since I have had a lot work on this knee, and the cadaver bone will take some time to "mesh", as he called it, he wants to go slow.
 

Celle

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He sounds sensible. I'm glad you have him.
 
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LolaBee

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Tomorrow will be 6 weeks post OP.

Week 4 I had my Outpatient PT evaluation. Driving myself to appointments with no problem.

Week 5:
PT is mostly gentle stretches and exercises. Hip pain is somewhat better. Foot pain and feeling of a tight band around foot and



ankle is still very much a problem. PT tried taping bottom of foot. It didn't help with tight squeezing sensation, but did help settle my plantar fasciitis. After a couple of days, the tape began to burn my skin, so had to take it off.
Working mostly on my gait. PT told me to stop using immobilizer brace as it was causing much of my poor gait and hip pain.
I'm not having much knee pain, but swelling is extreme. Spending a lot of my day elevating and icing.

Week 6:
PT is a little more intense, but still gentle. Ten minutes on sit down stepping machine, set to very mild resistance.
Can not tolerate tiptoe exercises. Still too much pain in bottom of foot. Lots of massage and even tried ultrasound treatment on foot and ankle. Still lots of foot swelling.
Used squat machine set on easiest, highest setting. Quads tender, but not really painful, but they were sore the next day!
Tried climbing stairs. Not pretty, and took me a long time, but I did it. Going down was challenging!

Over all, I'm sleeping mostly through the night, knee pain is minimal, but foot pain is severe.

Went to OS appointment today. He's very pleased, and surprised at my progress. Not really wanting to discuss my foot problem, other than give it more time.

Still trying to get my overall strength back. I'm not anemic anymore, but still get tired and shakey if I over do it.
 
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LolaBee

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I am trying hard to be a patient patient. :angel:
 
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LolaBee

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Week 7

This weekend, I walked for 1.5 hours in the grocery store, pushing the cart. No problems there, and knee actually felt good. Paid for it that evening with swelling and pain, but not severe.

Had PT today. Ten min on step machine to warm up, then the rest of session was addressing tight hamstring and tendons in back of knee. Lots of massage with stretching and working on massage to push edema from lower leg. My therapist wants me to start using the PED sock again, as swelling and lower leg circulation is still a main concern. Hopefully will help with continuing foot pain and swelling, too. We did not work on bend today, but concentrated mostly on stretching and extension. I'm at -3.
Because I have so much swelling, I was beginning to worry that I was losing a little flex, but he isn't concerned at all right now.

Resting with leg elevated, PED sock on, icing, and sleeping kitty on my lap. Life is good. :flwrysmile:
 
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LolaBee

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Week 8

Still dealing with lots of swelling, mostly outer quad area and foot. PT was a little rougher today, but not overly painful. Working on firing up new sets of muscles, particularly calf. After being non weight bearing for several months and 2 surgeries, I have significant atrophy, especially in my calf. My PT feels my foot problems will subside once I get muscles strengthened and swelling issues behind me. Still working on gait.

Over the weekend I walked the grocery store and climbed stairs without much trouble. Going down was mildly painful, but not too bad.

I had a suture poke out at top of my incision. My surgeon pulled and snipped it at last visit. Now I have another one that is trying to poke through, and very irritated. I'm nervous about any infection, so I am leaving it alone and trying not to disturb it. Will show surgeon at next visit in 2 weeks.

I ordered some pretty compression socks that should be here by week's end. If compression socks are going to draw attention, they might as well be bright and colorful! :heehee:

I ordered knee high socks. My therapist suggested I might try thigh high, too but I'll wait and see how these work first.

Did anyone else use thigh high and did they help? I have severe (half melon size) swelling on outer side area above the knee when at its worst.

It's a beautiful day. After elevating and icing after PT, I might go for a walk.
I am using a cane when out of the house. Mainly for protection in crowds and help with balance on uneven ground.
 
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LolaBee

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Week 9

Knee is coming along nicely. Not a lot of swelling, even after PT or over doing things. Incision sensitivity is almost completely gone. Overall knee pain is
0-1 most of the time.

Because I spent months basically bedridden, my core strength is poor. I've been having lower back pain and spasms, setting off pain in my groin and inner thigh on my non-tkr side. PT time is mostly spent working on relieving that. Have new exercises to do at home.

Weeks ago at my initial PT consultation my bend was 92. Another PT at the clinic told me I would probably only ever get to 95 due to all the work done in my Revision.

Today I was 108! Ha! Apparently that PT doesn't know how much grit this ol' gal has!! :rotfl::heehee:

In the end I dont care what the number is, I'm sure I'll be just fine doing all the things I used to do.

Reading back over all my posts in this "journal", I'm so grateful for improvement physically, psychologically, and emotionally. I was in some dark days in the beginning with the shock of knee infection and tkr failure and all the setbacks.

Onward I go, one step at a time.:walking:
 
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LolaBee

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Week 10

Follow up visit with Infectious Disease doctor after being off all antibiotics for 6 weeks. Lab results good. One marker was slightly elevated, but still lower than previous labs. He felt it was still within acceptable range (was .1 higher than normal range). He released me, and said since all the tissue samples taken at re-implantation surgery were negative, and cultures did not grow, he decided to keep me off antibiotics, with periodical lab checks.

Follow up visit with OS. He's very pleased with my progress. Swelling us still a major issue, and one that will be around for a long time. Stretching the hamstring, calf, and foot should be top priority.

OS was not happy with ID doctor's antibiotic protocol. He got the ID on the phone while I was there. Although I could only hear one side of the conversation, and with some difficulty from other side of exam room door, it seemed to be a clash of opinions! In the end, the OS got his way and I'll be on oral antibiotics for 1 year, with labs every 3 mmonths. Not looking forward to it, but also don't want to risk bacteria hiding out now, only to rear it's ugly head later. :scary:

Another 2 months of PT was ordered, so should begin again next week.

Lots of painful zingers happening in my shin area. Hoping those nerve endings are done finding each other soon! Yeowww!
 

sistersinhim

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You news that your lab results were good. I guess staying on antibiotics is better than a hidden infection still lurking there. I remember well those zingers. Sometimes they'd even make my leg jump up. That made the knee hurt!
 
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LolaBee

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The oral antibiotic I've been prescribed is Minocycline 100mg twice daily.

Has anyone else taken this?
 

Motherbone

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I've taken Minocycline 100 mg twice a day. I did not have significant problems with it. Occasionally it can cause some dizziness and I had fleeting light headed feelings but they did not interfere with my daily activities and they went away. You might want to take it slow when you get up until you are sure that's not an issue.
 
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LolaBee

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Week 11

No PT this week, still waiting on insurance ok for more sessions.

Knee feels great. Swelling mostly under control. Foot pain still an issue, but seems somewhat better. Lots of stretching and walking is helping.

Having a little trouble adjusting to the oral antibiotic, but not nearly as much as I had with the IV ones. Just slight queasiness, occasional moments of vague light headed feeling, and spending more time in the bathroom.

So far this week I have climbed flights of stairs every day, doing more deep cleaning and work around the house, and climbing a fairly high hill on our property daily. (Gravel road). All without much pain or swelling. If anything, I'm tiring before the knee complains. Going up the steep incline is slow, but using the cane. Downhill is more challenging, but not uncomfortable.

Still not sleeping well, but no pain at night at all. Just having trouble getting back to regular sleep habit after 6 months of this knee mess.

Overall, doing great!
 

sistersinhim

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Just slight queasiness, occasional moments of vague light headed feeling, and spending more time in the bathroom.
Have you tried eating something will a higher protein before taking your antibiotic? My stomach doesn't like them either, and I found protein helps with that queasiness.

Walking up and down hills it really difficult and you're nailing it! Good job!
 

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