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Revision TKR Right knee has problems again

Sounds great but I am confused?? Two weeks after my 4th TKR I developed MRSA ( not fun ) and went from heavy duty anti-biotics, PICC line, even had a spacer put in, after it was finally cleared up had my 5th TKR. This is where I am confused you wrote the Dr. is giving you a new knee and you will have no infection?? What I have been told there is always a chance and if you have had MRSA once the odds of getting another infection are greater then those that have never had an infection. Thats not to say its going to happen. It just seems odd that you will be given a new knee that will prevent you from getting an infection, never heard of that just wondering??
 
@NFenske I also had MRSA and PICC line, a second surgery to wash out the knee with a new spacer. My OS has told me that the cement he will use has an antibiotic in it and the knee itself also has some kind of antibiotic principal to it. He said this is what he always uses after an infection.
 
It sounds as thought your surgeon will be putting in a knee made from bone cement. If this is the case, it's actually the first stage of a two-stage revision. They have been known to last more than just temporarily these days, so the idea of it lasting for 5 years seems possible. At that point, presuming you've had no infection, I imagine he would go ahead and place a regular revision knee component.

Here is a description of the two-step revision process from the National Center for Biotechnology Information (NCBI):

Two-stage reimplantation is considered the gold standard for the management of periprosthetic joint infection. The first stage involves the removal of the prosthesis, followed by extensive debridement of all nonviable tissues, synovectomy, irrigation, and reaming of the medullary canals. Once the joint has been prepared, antibiotic-impregnated cement beads and/or spacer are inserted. Antibiotic-impregnated spacers are now more commonly used, and an increasing number of orthopaedic surgeons are using articulating spacers if indicated. Antibiotics are then prescribed to the patient based on the sensitivities of the infecting organism. The duration of systemic antibiotic use is decreasing, and short courses of antibiotic therapy have been shown to be as efficacious as prolonged therapy between the first and second stages. The second stage of the procedure involves removal of the antibiotic-impregnated cement beads and/or spacer, repeat irrigation and debridement, and final reconstruction with revision components.
 
My understanding is that he plans to use a regular spacer and not an antibiotic one. I’m not sure if that’s a reason it will last longer. I’ve already have had a debridement and have had my antibiotics both IV and oral pills. No tests done recently showed any infection so unless some of the swabs taken during the surgery shows something then I won’t need antibiotics.
 
@newlybionic I wish you well with your upcoming revision surgery. I'm concerned there may be one in my future also. My OS is chasing what might be a low grade infection. Not all the test results are back yet.

But I am curious where you are having the revision done. I notice you are in the Poconos, and I'm not far away in Allentown. I'd be interested in how you picked you OS for the revision and is he a specialist in revisions.
 
@BillinPA My doctor is in Allentown. He is part of OAA on Centronia Rd. His name is Dr Pollice. He did the revision on my left leg after an OS in the Poconos screwed it up. My surgery is going to be at coordinated health in Allentown.
 
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@newlybionic Thanks for the info. I actually went to Pollice many years ago for a cortisone shot in my right knee which has been pretty good ever since. I've had problems with my left knee for the last three years and switched to Coordinated Health, which is now part of Lehigh Valley Health Network. A Dr. Meade did my LTKR a little over a year ago.
 
It’s getting close to my surgery and I’m getting very nervous about it. Since it’s my right knee I won’t be able to drive for a while and I have no one local who can drive me. I’m getting the COVID vaccine this week and I’ll need to get back to my hospital where I work to get the second shot a little more than a week after my surgery. I have someone who said she would take me but she’s very unreliable. I’m hoping to find an emergency back up just in case.

My post op visit is Feb 3rd so I will need a ride then. I can’t use Uber as both of the trips I’m taking are far away from my home and would be very expensive.
 
Fingers crossed you will find someone to drive you, could you not ask support from your local church or even the hospital you where work. Alternatively could you not stay somewhere closer for a few nights.
As most of our surgeries, due to the enormous waiting lists, we are now being offered surgeries in different parts of the country, most likely my forthcoming surgery next year will be in the Centeral /North of Portugal, in which case I would rent a airbnb/condo for the 1st few weeks to be closer to the hospital.
 
I have to take a COVID test tomorrow as part of my pre-op. I’ve been cleared by my PCP ( primary care physician) for surgery. I start tomorrow to do the pre-op antibacterial washes on my knee and mupricion treatment to my nose for any MRSA colonization that may be present. It’s getting real now! 6 days and counting.
 
I’m sorry you don’t live close to anyone that you care about-that could take you. I know your talking about the ride, but, I’m sad that you don’t have someone to just be with you to be a support- no matter how prepared or past experiences- surgery is still scary to go through-right now the hospitals in the area I live (Minnesota) aren’t allowing anyone with or to visit unless you are in critical care- that makes it harder too.
is there anyone who could come be with you before and after at least a couple days on either side-that maybe your just not asking because you don’t want to ask it of anyone?
 
@newlybionic Would your insurance cover a medical care car to take you home after surgery? That's how I was delivered home after my BTHR. I'm not sure how you'd find out about that ... maybe your surgeon's office or your insurance carrier or a hospital social worker might know.
 
I do have a friend that will be staying at my house with my three dogs while I’m in the hospital. She will stay until the weekend or a second week if I need her. My middle daughter will come to pick me up from the hospital and take me home after she is done with work for the day. I might not be home until the early evening but that’s ok with me.

I have medicare and I don’t believe that Medicare provides transportation to my home from the hospital. It’s an hour away and I’d rather wait for my daughter with her SUV to pick me up. It’s easier to get in or out of it.

Two weeks after my surgery I have to go back to the hospital where I work to get my second COVID vaccine. My sister or one of my other daughters will come to take me there. I will just have to walk a little bit and then take an elevator to the area where they are giving the shots. If I need a wheelchair my manager told me to give her a call to take me up since she’s due then also.
 
@newlybionic Marian It sounds like you have things very nicely set up! I wish you all the very best with your up coming revision! :angel:
 
My COVID test results are negative. So I have completed everything needed pre-op. I will get a phone call on Monday telling me what time I should report to the hospital. This is getting real!
 
Isn’t it crazy how it seems so far away but then all of a sudden it’s so close you can’t believe it....
 
@Cococay Definitely. I’ve been planning on this surgery for months. I had to wait until January because my daughter got married in December. 3 more days! Yikes!
 
My last night before surgery. I’m to be there at 10am. I’m not sure what time surgery is. I’ll see everyone on the other side!
 
All the best tomorrow, looking forward to seeing your first post on the other side!

Just incase you would like a review, here is a copy of the Knee Recovery Guidelines.

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​
ice​
take your pain meds by prescription schedule (not when pain starts!)​

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
​

6. Access these pages on the website
​


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 the 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 the member’s history before providing advice, so please post any updates or questions you have right here in this thread.
 

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