TKR Post surgical Staph Infection Questions

[iamru706]

I had originally seen my OS because I was having L knee pain and needed a TKR. At time of visit he suggested Synvisc injections in both knees. In turn the injections caused enourmous pain in my R knee. I was given MRI and Xray and was told R knee had tear and need arthroscopic surgery. I was then told after that surgery that my R knee was a huge mess and that since I had no relief, they recommended a TKR of my R knee. So in May 2007 I had R TKR. Post surgical could only get 90-110 degrees so OS performed to post surgical manipulations. One in July 07 and another Aug 07. I never had improved range of motion or flexion even after these procedures. I was still very swollen and my knee was hot to the touch. I had several attacks of pain that was so bad I ended up in the ER and was given morphine. I sought the advice of another OS approx 11 month post op and he suggested I wait a few more months to see how I was feeling and if still in pain would re-replace my TKR. This Jan 2009 I had yet another attack of pain and ended up in ER again. I was referred back to PCP that referred me to yet another OS who ran several blood tests and also drained my knee. Turns out I have a staph infection. Feb 18., had my R TKR removed and an antibiotic spacer and rod inserted. I have a pic line that I receive daily antibiotics in. If all goes well and the infection is cleared up April 29th will be the surgery date for my new TKR. I have tried to have a positive upbeat attitude that this will work. I just keep hearing nightmare stories to the contrary. Anyone out there that has been in my shoes and how did it go for you??? Thank You

 

[Nursepair]

Welcome Iamru706, so sorry to hear about your problems. It is always our biggest fear. Hopefully the next one will go smoothly. The infection must have started during your surgery, that is terrible.

Haven't experienced this myself, and hope I never will. Jo, our moderator and former nurse has just had a TKR so may not be by just yet, Jaimie is standing in for her at the moment.

Hope all goes well for your next op in April. Good luck. Sue

 

[Jamie]

Iamru.....wow, what a story!!! I am so sorry to hear all you've been through. We have had a couple of people on the forum who have been through an infection and the replacement process. I think it is difficult, but you just get yourself through it. An important thing is the respect you have for your attending surgeon. Are you happy with this one? Lots of trust in his ability? This is critical!!

I'm curious....are you in a small town or a large city? And are the doctors you've seen all in different practices? I cannot believe that the first doctor didn't check for an infection with the swelling and heat on your knee. Amazing.....

Bless your heart for keeping a good attitude during all of this. I can see why you feel it's been dragging on forever. The good news is you found this forum and now you have a very large, caring family of people who can understand your fears and your feelings and who are available 24/7 to help and support you. Use the forum in this way as much as you need to. Do you have family nearby to help also? Believe me, we ALL care about you and will help you get through this.

 

[Nana55]

I had knee replacement in Dec 08 and had to have manipulation but haven't had issues with infection. A guy I go to therapy with has been dealing with this issue unforunately for about 3 years BUT the good news is at this time, he is doing well. They worked to make sure the infection was cleared up before they put another replacement joint in.

I know this has to be hard for you, so sorry to hear that you are having problems. Jo should be back soon and maybe she can share some insight since she has a great many years of ortho experience and Jaime may know be able to assist you.

 

[PRGal]

Iam, there's a fella from the hippie side that's going through exactly what you are--PICC line, spacer & awaiting replacement--except it's a hip instead of a knee. Do a search for Tommy Utah in this forum and you'll find his threads.

 

[Jamie]

Thanks, PR.....you're right that even though it's a hip instead of a knee there may be a lot of common issues. It does so help to have someone to talk to who knows exactly what you're going through.

 

[Coppernob]

Hi lamru and welcome to the forum. I'm not sure that I can answer any of your questions as I'm at the beginning of the treatment for staph aureus infection, but as there don't seem to be too many of us on here, I thought I should make contact. I has bilateral UKRs in Aug 2005. The right knee has been more or less ok but I've had major problems with the left. In April 08 it was changed to a TKR and then last November I had to have the tibial tray replaced as it had come loose. Just over 4 weeks ago I developed an infection in the left knee joint and was readmitted to hospital. I had an aspiration followed the next day by a total washout, debridement and replacement of the plastic spacer. I'm now part way through a 6 week course of strong antibiotics and, until I finish them, I wont know whether the infection has cleared up or whether I'm going to have to go down the removal, spacer and replacement route. It feels as if I'm sitting on a time bomb that could go off any minute! I do hope your infection clears up and you're able to have the replacement next month. Like you I try to be positive but it's not always easy is it? Perhaps we can encourage each other. Linda

 

[iamru706]

Thank you all so much for your gracious welcome and information. I truly am so happy that I have found this site and look forward to using it. To answer some questions I do love the new OS that I am seeing and am happy w/ him. Still cant figure why the Ols OS never checked for infection. I live in Pittsburgh, Pa. I do have help. My friend has been letting me stay at her house since its very handicapped accessible and mine is NOT! Steps, Steps, Steps! My dear 75 yr old mom helps alot too. My kids are in their 20's and try to help when they can. I did read Tommy Utahs posts - he has such an awesome perspective!!! Thanks again to everyone!!

 

[iamru706]

Linda,
I feel your time bomb pain!!! I hope you have a supportive group of people around you. I will be more than glad to take you up on your offer to encourage each other. Are you currently w/o any knee joint? I am. I should be finished w/ the antibiotics march 30th, then see doc 2 weeks later to see if we will procede w/ TKR. No guarantees of course, but prayers and fingers crossed all will go well!

 

[Jamie]

God bless you, Iamru....you are an inspiration to all of us. What a wonderful positive attitude. I will be praying that this crisis passes soon and you are on your way to recovery. Post any time you need a little boost....we'll be here for you!!

 

[Coppernob]

Hi iamru

Thankfully I have a good support network, led by my husband, but I know there are others I can call on if necessary. I also have a huge number of people whom I know are praying for me.

At present I still have my knee joint but the surgeon has told me that there's only a 30% chance that it will be able to be saved. Following the washout I was on IV antibiotics for 6 days and then sent home with a 6 week supply of oral 'bombs'. I'm having regular blood tests to see if the infection is subsiding and at the end of the 6 weeks Mr T will decide whether it's cleared up enough for me to keep this knee, or whether I have to have it removed and, eventually, a new one put in. It's the uncertainty that I find difficult. At the moment it feels as if life is on hold - we can't forward plan as we don't know whether I'll have this knee, no knee or a new knee and if the latter, when it will all happen. I guess it must be the same for you waiting to know whether you can have your new replacement in April or not.

I see Mr T again this afternoon for the results of the last blood tests. Last week I was feeling much better, but this week the pain deep in my knee has returned although outwardly it looks fine. Will let you know what he says. Hope you have a good day. Linda

 

[Coppernob]

The latest on the knee - I went to the hospital this afternoon but saw one of the consultant's underlings rather than the man himself, who didn't seem to be around at all. This was one I hadn't seen before so it took him a while to go through all my notes and history. (It looked as if someone had dropped my file and just shoved things in anywhere.) Eventually he found the blood test results from 2 weeks ago and the infection level has dropped which is good news. But this week the knee has become very painful again and I haven't been feeling so well so I've had more blood taken and if there's a problem someone will ring me tomorrow or Monday. Otherwise I go back in 3 weeks time. So the waiting continues........ Linda

 

[iamru706]

Linda,
I am keeping you in my prayers that all will go well with your results. I have to say their are times when I too do get that deep pain in my non existant knee. I would say that since that was the case I started to get wooried last week, but when I called the doctor the report from the levels of my weekly bloodwork seemed to be good. To make myself think more positively I make myself believe the pain is from when the antibiotic is working on the infection. May be crazy,makes me feel better! Keep your chin and your leg up! Well beat this together! I have 2 more days of antibiotics and then I get to lose the PICC line hopefully! Then I go see the doc in 2 weeks to see if we can procede w/ TKR on 4/29/09.
Have a better day,
Eileen

 

[Sticker Lady]

Hi Iamru!
Welcome to Bonesmart, I can't give you any advise since I'm still in the "waiting room" for BTKR but I wish you all the best and will keep you in my thoughts and prayers.
Blessings, Irene

 

[Coppernob]

I bet you'll be glad to see that PICC line go, Eileen. I still have a week and a half of antibiotics to go, and then the decisive blood test to see whether the knee needs removing or not. I keep telling myself that someone has to be in the 30% who don't need another replacement.

The doctor from the hospital rang on Friday morning with the results of Thursday's tests. He said that the infection level hadn't gone up but implied that it hadn't gone down either but as long as it's not on the up again I'm happy. I see my surgeon again on 16 April which must be round about the same time as you see the doc. My chin and leg are well up - hope yours are too! Linda x

 

[Judles]

Linda & Eileen,,,,, A few more prayers
Lifted your way can never hurt!!!!!!
Both of you are very brave indeed!

 

[iamru706]

Thanks again to everyone for your kind thoughts and prayers. Last Wednesday I did have my PICC line removed, Yippee! I am just waiting for my doctors appointment on April 16 to see if we can proceed ahead with the next total knee replacement. I am counting the days, hours, minutes....lol. I think the hardest part is the uncertainty of the outcome and also the boredom getting to the next step. I am hanging in there as I hope my Linda is as well!
Take Care and know you are all in my thoughts in prayers!
Eileen

 

[Jamie]

Good news, Eileen!! I'm so happy for you. I know you are anxious to meet with the doctor on the 16th. It will be here before you know it. I'll be praying for more good news.

 

[Josephine]

I missed this in my absence! I'm so sorry to hear you are having these trials. There's really not a lot I can add except to wish you all the very best and pray those blood counts come tumbling down!

 

[Nana55]

Eileen and Linda,
Gee it sounds like you have had your share of pain related to staph but thank goodness you are responding to the antibiotics.

Staph infections are becoming more of a "Norm" these days and that speaks to the strength of bacteria that are out in the world. It is on our skin and so many folks today are colonized carriers. Maybe when they get robotics perfected it will take out some of the risks because the robot can do the surgery. Oh!! That is something to think about. Oh course that is assuming they disinfect the equipment.

Things are scary these days. Prayers that you both continue to show progress and get the infection cleared up.