Knee Infection staph infection on LTKA

[DodgyKnee]

@skygirl I believe serrapeptase is an enzyme you should look into. Apparently it has an effect on the biofilm on the prosthetic and so enhances antibiotics.

 

[skygirl]

Thanks Dodgyknee, I went to a naturalpath doctor and read a really good book about MRSA and staph and they both agreed Biocidin, Interfase plus and oliverex in combination with an antibiotic was effective against staph. Seems to be working, no pain, still have swelling. I'm going to the Stanford Infectious disease clinic next week where I will see an ID doctor and an orthopedic...getting to the bottom of this . Knee does not feel stable and lower leg seems to be loose.,,has back and forth movement below the knee. I don't think that's normal but does anyone else have a lower leg than can be shifted and not solid?

 

[BBCG]

Whoa, Skygirl, infections are scary! I wish I had a good referral for you, but I respond because my DH just has been dealing with a bone infection stemming from a stroke last year. There is a highly thought of infectious disease specialist here in Eugene OR, at PeaceHealth Riverbend, named Brenda Ormsher. The docs Dan saw in the ER were saying he would lose the toe the next day, but they'd try a round of antibiotics over night in case that would help. When the surgeon returned in the morning, Dr. Ormsher was already in the room and she waved him away, saying she could deal with this; the toe was staying! They all deferred to her and she has been correct. His infection is nearly gone now, 2 months later. I do not know if she has lots of experience with implants and replacement knees, but there are lots of them done there, however it is not listed on the list of their treated conditions. She is not in northern CA however! She is also on the staff of the hyperbaric health center at Riverbend, too. I'll follow your progress here and will send you healing energy as well!

 

[skygirl]

Thanks BBGC, I will keep her name if I need to consult another ID doctor. Thank you!!

 

[Josephine]

but I don't have the oozing or open wound.

It's actually less common to have an open, draining wound with PPI. Have you read our Library articles?

Infection: Peri-prosthetic infection - also known as late onset infection
Infection: Periprosthetic infection (Scientific Articles)
Infection: Peri-prosthetic infection: study by the Mayo Clinic concerning prophylactic antibiotics (Scientific Articles)

I do have Dr. Maale on my list but he is a plane ride away

Dr Maale will discuss over the phone and review your notes, reports and xrays if you ask him. You don't necessarily have to go see him face-to-face.

 

[skygirl]

Thank you @Josephine ,
I read the articles and they were very informative. I am seeing the ID and ortho doctors at Stanford. I went to another ID that had no clue about prosthetic joints and tried to treat it as a normal infection. She gave me Rifampin and levofloxcin. Rifampin makes me sick but levofloxcin was a nightmare! My joints swelled, severe headache, dizzy, fuzzy brain and could hardly walk...all that from 1 pill!! Stopped taking it and had residual effects for days after. Went on Rifampin and erythromycin, then only erythromycin (susceptibility test was positive for both)
Since you have had 2 knee replacements, are either of them movable below the knee when relaxed? It feels like mine is a bit unstable and the tibia and fibula feel like they shift a bit, especially when I walk. Sometimes I have pains in my lower leg and constant numbness that goes to my feet and cramping in toes. (Will have to copy this to take to doctor) Could this be due to the spacer, malrotation, or do you find this to be normal?

 

[skygirl]

Hi @RestAssured,
What was the procedure for your single phase replacement? Did they treat the bacteria prior to replacement ? Did you have the entire prosthetic replaced? What was your recovery time? Sorry for all the questions, but I'm getting all the info I can. Thanks

 

[Celle]

@skygirl
Since you asked Josephine a question, I have edited your post, so that it tags her. That way, she will be sure to see your question.

 

[Steve4kids]

I hope you do well. I have been fighting.
Very similar things you have been going through.
I rode a bike last week, a major victory, very happy.
I have rom of 90, I'm very pleased .
I have to take Dioxyciclene anti body everyday for life.
Still might come back, but it can get better and I'm walking
And have a leg. Good luck I'm sure it will only get better

 

[skygirl]

Thank you Steve4kids, glad to hear you are able to be active. I went to Stanford Boswell Joint Clinic today and spoke with an Infectious disease doctor and an orthopedic doctor that specializes in difficult problems with tka's. Not good news but expected. Need revision to get rid of infection, also, prosthetic is malrotated and needs to be replaced in order to gain stability in the knee. Looks like operations 4 and 5 for me but at least I can go back to work for 2 months before the operation. Expected this by all I've read, and at least I now know the problems but not looking forward to the surgeries and the pain ;-(

 

[Celle]

I'm sorry t hear your bad news, but at least you are now under the care of doctors who know what they are doing. It sounds as if your PKR would have had to be revised at some stage anyway and this time it will be done by a surgeon who speciaises in difficult cases. That's good.

Do keep us updated with you progress.

 

[Steve4kids]

I know, multiple surgeries hurt. I'm afraid of them. I am scared it will come back. Only the few
In this club can know what it is. I think women handle pain much better than mem, at least this man
It sounds like you are in good hands at Stanford. I had my revision done at USC Keck Hospital, Daniel Oakes
Head of joint replacement, he only does revision only.I D doctors give me antibiotics still does. I think he did very well with the mechanics of my knee. I researched and I decided on him. I'm glad I did.
I don't know how to post well, but, several years ago I received so much encouragement from people on this
Site, I got hope, and now , hey I'll take what I got gladly. I don't go on this website much now. I'm getting on with my life. My best wishes to you. You will get thought this and can be better for it.

 

[greatlakes]

I'm so sorry you will have to cope with more surgery but mainly so happy for you that there us a solution, and a dr willing to accomplish that solution. Now you have a plan, and can deal. Best wishes, Audrey

 

[skygirl]

Thank you all for your kind words of encouragement. Funny @Celle, I did not mention the PKR, but you are right, new doc didn't like the looks of it and said I got my use from it for 3 years.. haha..but not thinking on that one as yet, just need to get the infected one taken care of first..after the problems with left knee, think I would like to keep as much of my real knee as possible. Maybe the stem cells will be perfected and available by then

 

[KarriB]

Are you having an antibiotic spacer put in and do you know when?

 

[newlybionic]

I'm sorry to hear you need more surgery. At least now you have doctors that can handle your specific problems. I had a revision (there was no infection but not placedo correctly) and it was amazing how much better my knee was. My recovery time seemed easier too.

 

[skygirl]

@KarriB the doctor was saying an antibiotic spacer (6 weeks) plus antibiotic cement...have to verify procedure. He wants to do it November. I have to be off antibiotics for minimum 2 weeks. Feeling apprehensive and thinking I may need another opinion. My doctor didn't think the trace bacteria was an issue but new doctor did. Went off antibiotics last sunday, taking herbal formula, will see if pain returns. He said I have had this infection for awhile, one leg was always darker than the other and having night and day sweats (finished menopause a while ago, don't think it is that) and headaches.(can't enjoy my glass of wine without a headache)
@newlybionic, how did your knee feel when it was malrotated? Did it feel unstable? Did the lower leg shift forward and back and side to side? Did it slip to the back sometimes? Did you ever have the tibia or fibula dislocate? Sorry lots of questions but I want to make sure I need these operations! Thanks all for sharing your stories and caring!

 

[KarriB]

Most infection patients with a spacer are off antibiotics for a period of time before the 2nd surgery, to be sure the infection doesn't return. They usually do IV/PICC line antibiotics while the spacer is in, pull the PICC line and wait. Most IDs will run blood labs to check your levels throughout the process.

Have you thought of contacting Dr. Maale for him to look at your info? I found it important to have confidence in my docs throughout this procedure.

 

[skygirl]

@KarriB I contacted Dr Maale's office and I would have to fly there for a consult, he doesn't consult sight unseen, which might be my option. However, reading @RestAssured back notes, seems she had to fight him for treatment.
Going to my original doc next week, will have a talk with him. He can do a bone scan to see if infection is there. He's an excellent doc and I am giving him the chance to fix it. Otherwise, there is a revision specialist at UCSF that I will have my doctor send me for consult. The Stanford doctor is good, smart and young ( fellowed at Mayo clinic) but my doctor is rated higher, I have a good relationship with him and he is noted to fix other docs mistakes. (Now for his own haha). I will see next week.

 

[KarriB]

Which doc has don the most revisions/infections?