Knee Infection* TKR2019 Revision 2021 Now possible infection

[Romans8:28]

Hi all. My revision has given me an amazing stable knee. Done 05/2021 I have constant swelling and it now seems I may have an infection. I developed cellulitis just below the knee and my GP tried 5 weeks of antibiotics that worked to an extent but has not solved it. Maybe it is Erythema?? Aspirate came back clear today however Revision specialist wants it done again as she thinks the first sample was too close to antibiotics. I am Repeating aspiration in 3 weeks and wait for results.
I have good mobility - I want to know what would be the result if I did not have this repaired assuming it is infected. I am unusually tired which I wonder if it is the result of the low grade infection. Knee is warm and so is the cellulitis/erythema.
I don't desire a revision of a revision but it would seem that there is no other option if this is infected.
Any comments, links or help would be appreciated.

 

[sistersinhim]

@Romans8:28, you don't know how many times I quote that verse! Welcome to Bonesmart. Would you please give us the history of your knee? We would like to know the surgeries you've had and the exact dates of them. Once you post those we will add them to your signature for you. Being able to see these dates at the bottom of each of your posts will be very helpful.

Do you have an infectious disease doctor? I think that's a must for your situation.

I know you had your surgery a while ago, but I'll still leave you our recovery articles for your reference.
Each person is different as is their recovery. Most find that the Bonesmart approach works best for them, but others find that a more aggressive therapy helps them more. It's your recovery and your choice on how you recover. As you read more on other members' recovery threads, you’ll get a better perspective of what to expect. The following are our basic guidelines and should help get you started.

Knee Recovery: The Guidelines

1. Don’t worry: Your body will heal all by itself. Relax and let it. Don't try and hurry it, don’t worry about any symptoms now; they are almost certainly only temporary.
2. Control discomfort:

rest​

elevate​

ice​

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

don't overwork.​

3. Do what you want to do BUT...
a. If it hurts, don't do it, and don't allow anyone to hurt you.
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again for a few weeks.
4. PT or exercise can be useful BUT take note of these

the BoneSmart view on exercise​

BoneSmart philosophy for sensible post op therapy​

5. Here is a week-by-week guide for Activity progression for TKRs


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 a 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 history before providing advice.

Try out our great new opportunity to improve your gait. It's OneStep. It's free and you will find it to be a huge help to you. Click here: OneStep

 

[Jaycey]

I want to know what would be the result if I did not have this repaired assuming it is infected.

You need to get this treated I am afraid. Waiting just is not an option. The infection will only spread and can cause real damage.

Is there a plan for getting you started on antibiotics? I guess you need to wait for the second sample to be taken before they can move forward.

Meanwhile please keep us updated!

 

[Jockette]

Do you have an infectious disease doctor? I think that's a must for your situation.

I agree, if you do have an infection, be sure you have an infectious disease doctor on your team. They will be able to determine which medication will be best for you.

 

[Romans8:28]

Thanks for the replies,

TRKR 12 Dec 2019
Revision TRKR 10 May 2021
Arthroscopy RK 1980 (cartlidge damage)
Arthroscopy RK 2000(? futher cartlidge issues)
No i do not yet have an infectious diseases doctor, however one was consulted by my GP after 5 weeks of oral antibiotics had not resolved the 'cellulitis' issue just below my right knee. He gave an opinion that if infection of the prosthetic joint was possible that the orthopeadic doctors need to follow up with microbiology etc. This is what is happening, but I will ask the revision specilaist at what point an infectious diseases doctor will be part of the team. My follow up aspiration will be 12 July and two weeks for results.
Currently I am in Christchurch (NZ) for a few days and had a day walking around the city. Knee hasn't responded well with being used for quite so much walking and stairs!

 

[LaJudes]

I too , had cellulitis and a small lesion just below my knee . I was treated with antibiotic but it never really resolved . Always came back in the same place A MRI showed a sinus track coming from under the knee cap area and tracking down to below the knee cap and then the surface . I had a 2 stage revision surgery with 6 weeks pic line antibiotic IV , leg immobilized for a total of 12 weeks , finally got the second stage of the revision 12 days ago . I am a bit upset that the orthopedic doctor wasted so much time trying to treat the infection and it got worse , they were treating me with antibiotic for almost a year ! I lost a lot of bone due to the infection and had to have a hinged knee replacement due to the instability of the knee .

 

[Romans8:28]

Thanks so much LaJudes - your situation sounds much like mine. I was half way to the surgeon last week only to get a call that she had tested positive for covid!! I see her again next week and she will take further fluid for testing. It is dragging on!! I am well armed with lots of questions and will certainly ask about MRI investigation as well. I trust that the new implant works well for you.

 

[Romans8:28]

Hi all. A brief update. My second aspirate has come back negative - hopefully that is good news as there is no way I desire a revision of the revision. My Revision specialist wants to take a conservative approach and review in another six months. I am still quite swollen in the knee, stiff and it doesn't appreciate me standing for any long periods. The discoloration below the knee to the right side is still there but not as much as it was before I had the 5 weeks of oral antibiotics! The surgeon will not engage Infectious Diseases people without a verified infection. In the mean time my left knee knee is going out in sympathy. I have been nursing this one along since the year 2000, a 2012 MRI showed a fairly extensive horizontal tear of the medial meniscus, but we decided against surgery because I would have been bone on bone (I guess i have had a good 10 years since then of a reasonable knee)... Now something is out of place and making me walk like a lame cowboy. Xray tomorrow and referral to a specialist after that...

 

[sistersinhim]

Negative sounds really good! I pray you can get to the bottom of what your knee's problem is.