TKR Risk of infection after knee surgery

[mjw82704]

Hi everyone!!!
I’m posting to ask for your advice from your experience. I waited for my knee surgery thinking it could feel better with exercise and wound up in severe pain. Now I’m at work with crutches and in a lot of pain. I tried to move my knee replacement up in time. The surgeon said yes but warned me of risks that will be there early one being higher chance of infection due to the cortisone shot having been within this past week. Plus I have a higher BMI which is also cause for higher risk of infection and last but not least I get inflectra infusions which lower my immune system too. If I wait til the end of November the cortisone will have left my system. Hopefully I will have lost some weight but the inflectra is still an issue.

What would you do in this situation? I sent my doctor a message asking about the risk of the three concerns compounded hopefully he’ll be able to give me an estimate.

 

[Layla]

Hello and Welcome to BoneSmart!

I am sorry you’re in severe pain. This decision is really between you, your surgeon and primary care physician since they have your full medical history. I would trust the medical professionals to help you decide next steps.

i will leave some pre-op reading material for you with best wishes for your comfort and in making decisions as you move forward. Once you schedule a surgery date, please let us know so we can support you on your journey. Thanks for joining us!

KNEE PRE-OP ARTICLES

If you are at the stage where you have joint pain but don't know for sure if you are ready to have surgery, these links may help:

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Score Chart: How bad is my arthritic knee?​

Choosing a surgeon and a prosthesis​

BMI Calculator - What to do if your surgeon says you're too heavy for joint replacement surgery​

Longevity of implants and revisions: How long will my new joint last?​

If you are at the stage where you are planning to have surgery but are looking for information so you can be better prepared for what is to come, take a look at these links:

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Recovery Aids: A comprehensive list for hospital and home​

Recliner Chairs: Things you need to know if buying one for your recovery​

Pre-Op Interviews: What's involved?​

Regardless of where you are in the process, the website and app My Knee Guide can help you stay organized and informed. The free service keeps all the information pertaining to your surgery and recovery in one place on your smartphone. It is intended to be a personal support tool for the entire process.

And if you want to picture what your life might be like with a replaced knee, take a look at some stories of amazing knee recoveries

 

[Jaycey]

@mjw82704 Most surgeons will not consider any surgery until at least 3 month post an injection due to the risk of infection. But Layla is right - this is something you need to discuss at length with your surgeon.

You ask what I would do - I would wait. Too many risk factors are not working in your favour at the moment.

 

[benne68]

I would also wait. In fact, that is what I had to do for my TKR 2 years ago. Because I'd had a hyaluronic acid injection in June, I had to wait until September for my surgery.

If it was me, I would wait the 3 months and use the time to lose a little weight in order to reduce my overall risk even further. But only you and your surgeon can decide what is right for you.

Good luck. Please come back a let us know.

 

[mjw82704]

Thank you for your reply’s. Any suggestions how to deal with the pain in my leg? It’s not in my knee any longer but the back of my thigh. I used crutches today at work and that helped but…. Any suggestions you have I appreciate. I can’t take ibuprofen due to my stomach issues (ulcerative colitis).

 

[Mutti3]

Use ice for pain relief. Don’t put ice on your skin, use a cloth barrier. A painful knee can aggravate everything!

 

[mendogal]

Thank you for your reply’s. Any suggestions how to deal with the pain in my leg? It’s not in my knee any longer but the back of my thigh. I used crutches today at work and that helped but…. Any suggestions you have I appreciate. I can’t take ibuprofen due to my stomach issues (ulcerative colitis).

I don't tolerate any NSAIDs either. My only non-opiate oral pain med is plain acetaminophen. My ortho recommends 3,000 mg total per 24 hours (so 2 500 mg extra strength every 8 hours). I have seen some recommend up to 4,000 mg/day.
After surgery, we use ice/cold packs to reduce inflammation. But while you're preop, for *chronic* arthritis pain many of us prefer moist heat. So you should try both or alternate. Also any of the topical arthritis remedies sold over the counter (menthol, capsicum, arnica, etc).

 

[mjw82704]

Thank you what do you mean by moist heat? Hot tub or bath?

 

[mendogal]

Thank you what do you mean by moist heat? Hot tub or bath?

It usually means either a warmed damp towel or a heating pad specially made with an insert one wets. But for those who respond well to heat rather than cold for chronic pain, yes a shower or bath, or even dry heat from a regular heating pad, will work as well. You just have to be careful - as with ice - not to subject the skin to too much extreme temperature.

 

[Nivea]

My OS will not due surgery until 3 months post injection. The ortho I saw prior to the surgeon informed me of that and it was my choice to forego the injection and wait for surgery. Fortunately, when I saw the surgeon, I was able to schedule in under 2 weeks for my LTKR. My pain was in the upper back calf, so I know what you are talking about. I hobbled around for the most part, nothing really touched the pain.

I will be having my RTKR in October and hoping my right knee doesn’t get that pain prior to surgery.

 

[PeachyKnee]

Thank you. I had read somewhere that heat might also be good to loosen up the new knee.It always worked before with me.Good info to have.

 

[mendogal]

Thank you. I had read somewhere that heat might also be good to loosen up the new knee.It always worked before with me.Good info to have.

Post op, just as with immediately post injury, you DON'T use heat. Your post op knee is "tight" because of swelling (inflammation), not because of tight muscles! It needs ice.

Heat is helpful for chronic conditions or for healthy tissues experiencing post-workout soreness/tightness.

 

[PeachyKnee]

Got it thanks.How long do you keep icing the knee?

 

[mendogal]

Got it thanks.How long do you keep icing the knee?

At a time? 45 minutes to an hour, since most surgeons want us taking a little walk every hour.
Ongoing, post op? As long as there is swelling and/or pain! First three weeks, anytime I was sitting in my recliner or with the Lounge Doctor. At about two months out, I was icing three or four times a day for 45 minutes. At three months out my knee, though still somewhat swollen, told me it mostly didn't want ice, so I put away the machine and just started using cold gel packs in the evening when it does want it. Everyone is different though.
Tip: You might want to post these questions in your own post op thread!

 

[PeachyKnee]

Ok. Thanks. I’ll try to move it.