Knee Infection Waiting for replacement after sepsis

[Sfs]

I had arthritic sepsis in my left knee 7 weeks ago. I spent 5 days in hospital on IV antibiotics, 10 more days on IV antibiotics and then 14 days on oral. The final culture came back negative! Yea! I knew I had “bone on bone” arthritis and asked my surgeon when we could do replacement surgery! He said he would not touch it for a year. At 72 years old I can’t believe I can’t get something done before that! I am (was) very active, walking, skiing, clogging, tapping! I am still using a walker with swelling and a lot of pain. Any suggestions?

 

[FourCats]

Sorry to hear you’re having to wait. Are you elevating and icing the knee to help reduce the swelling?

 

[Layla]

Hello and Welcome to BoneSmart. Thanks for joining us!
I’m sorry you’re dealing with pain and suffered the misfortune of infection.

I’m wondering what reason your surgeon gave you for the wait time he’s suggested? Possibly he wants more time to pass with hopes the infection doesn’t return. If that’s the case, you wouldn’t want to proceed too quickly and risk the chance of the infection returning post op necessitating an additional surgery via a revision. That could involve more down time, more antibiotics, a spacer etc.

I’m sorry you’re discouraged and wish you comfort as you await replacement surgery. Hopefully icing and OTC meds will help ease any discomfort and pain you’re dealing with while you wait. We’re here for support if you need us. I’ll leave you some pre-op reading material.

If you are at the stage where you have joint pain but don't know for sure if you are ready to have surgery, these links may help:
Score Chart: How bad is my arthritic knee?
Choosing a surgeon and a prosthesis
BMI Calculator - What to do if your surgeon says you're too heavy for joint replacement surgery
Longevity of implants and revisions: How long will my new joint last?

If you are at the stage where you are planning to have surgery but are looking for information so you can be better prepared for what is to come, take a look at these links:
Recovery Aids: A comprehensive list for hospital and home
Recliner Chairs: Things you need to know if buying one for your recovery
Pre-Op Interviews: What's involved?

And if you want to picture what your life might be like with a replaced knee, take a look at the posts and threads from other BoneSmarties provided in this link:
Stories of amazing knee recoveries

 

[Jamie]

Hi, @Sfs .... welcome to BoneSmart.

I'm certainly glad to hear you're testing negative after your sepsis infection. I understand your desire to move to a knee replacement as quickly as possible so you can regain your active lifestyle. It does sound as if your surgeon may be acting a little on the cautious side in telling you to wait a full year.

I could only find one older study on this subject from 2002 as it's not a situation we see very often. In that study, 16 patients were given knee replacements after their sepsis cleared up. Only one person developed a follow-on infection. All the others experienced good longevity of anywhere from 5 to 11 years with their knees before the study ended.

Based on that information, I suggest you talk with one or two other surgeons that are completely unrelated to your current doctor. It may be there are other factors in your case that create the need for the conservative approach. But you may feel more confident if you have that plan validated by some other opinions. When you search for surgeons to consult, be sure you are seeing someone who is an experienced revision surgeon. These are the doctors who are most likely to see people with problems with their original implant. If you need help finding a revision surgeon, just let me know.

 

[Sfs]

Thank you so much for your reply! I am seeking a surgeon now. I have been told I need to see an infectious disease specialist and then on to the orthopedic surgeon. Right now I just need some validation. That you again.

 

[Sfs]

What is strange about this knee is:
1. The pain is prohibiting physical therapy.
2. Icing, elevation does not bring down the swelling.
3. Non-weight bearing activities (walker) seems to help more than anything.

Thank you all for your replies!

 

[Jockette]

It is definitely a good idea to have an infectious disease doctor on your case when you’ve had an infection like this.

 

[Jamie]

Your approach is a good one so that you can make the best decision about how to proceed. Let us know how things go. We'll be here for you if your need us.