Knee Infection* TKR2019 Revision 2021 Now possible infection

[15kneesurgeries]

Hi Team,

Now upgraded membership and looking forward to some feedback. I am due to see my Surgeon on 6 August. We will endeavour (NZ spelling ) to come to an agreement on the pathway forward. Since taking up a second opinion with this OS, he identified potential loosening of the femoral component in Xrays, completed a Bone Scan which also identified loosening bur not extreme. A further Xray after another 5 months identified further loosening developing. He attained approval for taking aspirate (theatre conditions resulting in negative result) and also to do a full revision through the funding agency. Please see my above post, Peripheral Neuropathy etc.

I need clarity around timing of revision - it will need to happen some time. Is earlier better than later. I have no desire for a 3rd surgery. Am I better to let the loosening run its course and then seek replacement, or is there danger of deterioration that would be harder to recover from...

I look forward to your thoughts...

I've had many surgeries and too many revisions than I liked to remember. It becomes very painful, I'm not able to have a knee replacement anymore due to no more bone. I have a permanent straight leg rod in my leg now because of my femur being severely loose and me waiting too long to do anything about it. I wish you the best of luck!

 

[benne68]

Welcome to BoneSmart, @15kneesurgeries.

Please read about our two-level Membership Program and Guidelines for Posting.

You are currently registered as a Basic Member, which is very limited in terms of forum participation. It’s meant primarily for members who choose only to research and read on specific topics.

If you would like to share your recovery journey and receive personalized advice from our staff, you should join our Insiders Club. As an Insider, you will be able to start your own threads, chat with other members and receive prompt answers to your questions or concerns. As a non-profit, we depend upon the small subscription fee to keep BoneSmart available.

Best Wishes, and we hope to see you join the Insiders Club, so we can support you in your joint replacement journey.

 

[sistersinhim]

@15kneesurgeries, welcome to Bonesmart. Please tell us the dates of your knee surgeries, and we'll add those dates to your signature for you.

 

[Romans8:28]

Well I am 6 days away from my 3rd replacement in the right knee. I have been extremely careful about not scratching myself, and yesterday I put a relatively small scratch on my right foot - it has dried up and scabbed over and looks fine. Then today walking past a clothes rack, my thin skinned right arm was knocked and a small piece of skin ripped off!! All very superficial, but a real nuisance! I think I will be wearing long pants and long sleeved shirts for the rest of these days ahead

 

[Romans8:28]

Romans 8:28 is a fantastic verse and I know that with whatever outcome I have God has a path for me for my good and His glory!

I love your user name and I am also a believer. I’ll be praying for you.

Their testing came back negative from the Aspirate in late May 2025. In talking with them he is confident that they are correct and that we are dealing purely with a loose femoral component.

So, if I understand correctly, they don’t think you have an infection, but they are doing an “infection procedure” just in case?

Yes that he thinks there is no infection. Regarding the procedure on the day, I did not ask him if this is his standard manner of working on a revision. He is very careful about possible infection, only ever taking fluid from a knee in theatre, never in a doctors consulting rooms, considering the risk too high. I will ask that question however!

August 18 - just spoke to the Clinical Manager and my surgeon does all revisions that are one day surgeries in a two stage process on the day... Obviously he also does 2 stage for infections with the long gap in between...

I had a phone appointment with my surgeon this week. He is back from leave and so I clarified with him if he routinely does 2 stage revision on the same day for all revisions. He said only where he considers that there may be a low grade infection lurking. Clinical Manager was wrong!! He said it is an internationally recognized practice - I am glad he is my surgeon.
Further update, I have lost 11kgs (24lbs) over the past 3 months. I have been doing as much walking as possible and daily strengthening exercises. My quads are looking great! My knee still gives way, and even more than before - the femoral component is loose - can't change that from exercising! But I am as ready as I can be physically for this. Not looking forward to it, but looking forward to it! Romans 8:28 - read it!!

 

[Legseleven]

Wishing you well with it all. You’ve done great preparations.

 

[sistersinhim]

Romans 8:28 - read it!!

Yes, I am a firm believer of that verse, and quote it frequently!

I have lost 11kgs (24lbs) over the past 3 months.

What a wonderful accomplishment, even more so with that bad knee of yours!

 

[Jamie]

You’re going into this third surgery with such a great attitude. You should feel pride for the good work you’ve done with your weight, mobility, and general health. You’re primed and ready for success. I wish you all the best on your Big Day.

 

[Layla]

Love Romans 8:28 and hope it brings you comfort. Prayers for a peaceful week as you head toward surgery on Friday and also for an uneventful surgery and steady recovery. We're here for you!
@Romans8:28

 

[Layla]

Best Wishes tomorrow!
Please let us know how you are doing once you're resting comfortably back at home.
Will look forward to your first update.
@Romans8:28

 

[Romans8:28]

Hi all, my surgery went ahead on 17th and I was home on the 20th! Surgery was in 2 stages and took 5.5hrs. They used spinal and also a general anesthetic due to the length of the op. I was standing that night and walking with a frame and then crutches the following day. I am amazed at my mobility and I can actually walk without crutches, but I am not pushing that! I have had a lot of brain fog which I guess is common when your body goes through such extreme challenges.
Pain is well controlled and fairly minimal. I am using Paracetamol and Celecoxib (I have Codeine if I need it, but have not used any). I am doing 3-4 sets of exercises per day - they wear me out, but they are not excessive in any way. The wound dressing is a Negative Pressure Wound Therapy dressing. It was used because there was significant thick skin and scar tissue that needed to be removed from the knee. This dressing is attached to a control box that is plugged in to power, and this stays with me for 2 weeks (the box makes man noises much to the delight of my grand kids ). So there are no staples and internal stiches dissolve.
The knee parts came out with a bit of difficulty. Saying that, the femoral head was not binding to the femur very well. The surgeon considered the replacement was truly justified from all he saw. There was a lot of fluid and various cultures were taken. He still does not think there is infection in the leg. I am very pleased with the outcome. This is so different to the two previous surgeries on this knee. I am thankful for a great team of caring medical staff that enabled this, and thankful to God for His Grace in my life.
The one problem I did have was on the night following the surgery. I had dinner and later slept for an hour or so. I woke close to midnight and was felling ok. Flicked through my phone and began felling unwell. Eventually I though I better call the nurse and let her know. They were always quick to visit if called and when she came in I was unresponsive. She hit the emergency button, was trying to wake me to no avail. An ICU nurse decided to give me 3 chest compressions to wake me (my heart was beating slowly & bp had tanked). I woke up and very quickly felt fine once my heart was pumping faster. It was considered a vasovagal response and I was on telemetry for the rest of my stay. This was reviewed by a cardiologist and i will have a follow up appointment with him in the next 2 weeks. So there was some added excitement for all, and again I am thankful for the good staff and the Grace of God!
I think that the careful preparation has helped me significantly, and finding the right surgeon has proven a huge difference in treatment and care.

 

[EalingGran]

Sounds like you are doing well apart from that rather frightening episode. Just hope it turns out to be nothing important- maybe just a bad fainting episode from the prolonged anaesthetic meds.
Good luck!

 

[Layla]

Oh my goodness. Thankfully you notified medical staff when you did. That episode had to be frightening.
I hope you're resting comfortably at home and wish you the best for your appointment with the cardiologist in two weeks. Please keep us posted on your revision recovery progress.
@Romans8:28

 

[sistersinhim]

Thank God you had the good sense to notify the nurse and were taken care of quickly. I pray that it was something minor and will never come back!

Your surgery sounds like it went well and was the correct thing to do. Now, be careful to not overdo!

 

[mendogal]

I hope you've continued to do well and no more scares!!!

 

[Romans8:28]

Hi Team,
Two weeks and one day post surgery, and the difference between my previous two replacements and this one is astounding. I am doing very well, mobilising without crutches in the home. I function from bed as it is the best place to keep my leg raised (I work from my computer). I do four sets of exercises each day, and ice after each one. I have discovered that I need to prioritise a sleep each afternoon if i can, and it helps so much. I am eating well and peanuts are my best friend as a great protein snack! Pain is negligible but I continue to use Paracetamol and Celecoxib as prescribed and do not need the Codine. I do know when my next dose is needed as my knee gives me a gentle reminder.
My negative pressure therapy wound dressing came off 4 days ago and revealed a very well healing incision with no ooze. I no longer need a dressing. The picture below is today with my quads in both legs being tightened. I think you will see the swelling has reduced very well. When I go out (not often), the walking is minimal, and i use both crutches for safety. So pleased with the result this far and will be very careful that I do not push it. Thanks for your interest and support.

 

[EalingGran]

That all sounds good. Good luck.
I used to like a rest in the afternoon as well.

 

[benne68]

Great update. Glad to read that you are feeling so positive about this surgery and that the swelling is already coming down.

You are wise to stay ahead of the pain by taking the meds on schedule, icing and elevating. And that you protein-loading to encourage healing. Remember that you are still very early days in this recovery, so take things slowly.

You've got this.

 

[Jamie]

Your knee looks great for just 2 weeks out. This is wonderful news. Still continue to take things fairly easy for a while, even if you’re feeling really good. Your whole body is still recovering from the trauma of surgery and it’s easy to overdo things when major healing is still going on.

 

[Romans8:28]

Thanks so much for the encouragement. I am being very careful and do not intend to overdo it. I take the advice and look forward to continuing with further reports with progress. ROM is around 90, and very happy with that and hope to see that progress as healing happens and swelling reduces. As a third replacement in this knee, i also want it to be the last so looking for longevity with this one!!