Sore knee after revision

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the clem

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I had a total knee done Dec,06, got a bad infection Jan, 07. The knee after 8 weeks of strong antibiotics seemed to be getting better. I could walk some what comfortable and things seemed to be getting better. After about 15 months the knee was good to walk on but quit bending. It would only bend to about 70 degrees. After several months of PT the doctor tried to munipulate but with no sucsess. We schedualed surgery for Mar of 08 to go in and see what was up. When I awoke he had done a revision and explained that the old one had loosened up to the point where he just took it off with his hands no tools required. Now 5 months later I've got a knee that is very painful on both sides and nowhere near as comfortable as the first. Swealing is very bad and if I dont take pain meds I can't hardly function. The knee bends to about 106 degrees and +3 the other way. As time goes by it seems to get more and more painful and I'm at wits end. Any ideas out there as far as what could be going on, I'm begining to freak out. I did see a infect desease doctor who told me, that if you get a infection of the joint, the joint will have to come out. I will tell you that my doctor only replaced the bottom potion of my knee. The infection doc said in his 18 years of practice he has never been able to get rid of an infection of the replacement with out it being taken out a antibiotic block put in and then a revision. He said he can get the infection under control where your body can keep it at bay but there is always a chance that it will come back. One other thing that has bothered me is the fact that even after 5 months my knee is still hot. Excuse my poor spelling and I look foward to any suggestions. Thanks bobby
 
Hi Bobby
5mths is still early bobby had my revision done in May mine still swelling and getting hot more so now after my fall the OS said it can swell/get hot up to a year. My OS said no question with me, if there was infection a block would be put in fortunately there wasn't.He did a full revision with a longer stem and i recovered quicker than the original.If it was me and the problems you have had with your previous infection i wouldn't hang around i would get another opinion
My doctor did tell me as in all cases of joint replacement the bacteria is slow growing so any of us could end up with an infection.I hope this helps you a little Bobby Take Care
 
Bobby - I am so sorry to hear your tale of woe! You have certainly had a 'worst case scenario' not once but twice.

Sad news is, all of what the 'infectious disease' doctor told you is true. And more sad news, your case has been terribly mishandled.

When the surgeon opened you up "to see what was going on" he already knew you had had a serious infection and should have been no surprise to him that the prosthesis was loose. It would been more of a surprise if it hadn't! In fact, this should have been defined before surgery. There are ways and means of determining loosening by xrays and scans.

Then he should NOT have inserted another prosthesis right then. The proper procedure would have been to put in a cement/antibiotic spacer for at least 3 months with you on an intensive oral antibiotic course until the infection was totally eradicated. Not until then should another prosthesis be implanted.

My guess is that you still have a low/moderate grade infection in your knee. This would account for the pain, swelling, heat and increasing stiffness. You need to get this sorted as soon as you can. Like next week!

Have you discussed all this with your primary care physician? What does he have to say about it all?

I'd like to help as much you as I can but I need some info: like who was the 'infectious disease' doctor you saw? Is he an orthopaedic or joint replacement surgeon? Can you give me his name so I can research him for you?
 
Bobby I hope you are listening to Jo, my God you have really been put through it and must just be terrified. If I were you I would be seeing another OS for a second opinion. I am not a surgeon or a doctor but common sense tells me your OS should not have put the second knee in without getting rid of all the infection and that he should have replaced the whole thing. I will keep you in my prayers and hope you follow Jo's advice, she really knows what she is talking about. Rowdy
 
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