Infected Total Joint Replacement - Everything You Need To Know
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- čas přidán 21. 08. 2024
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The complication of infection in the setting of a total joint replacement is discussed including acute and chronic infections, symptoms, diagnosis, management, surgery, and more.
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I had a knee replacement six years ago. It has been infected the whole time. One year after the surgery we took it out cleaned it and replaced it with the titanium. Infection is gone into the bone,They suggest I have three more surgeries, no for sure results. My leg could end up shorter or amputated. Are used to be very healthy ,work out ,walk, and have a very active life, after two failed surgeries, I have lost hope in the doctors; surgery. I Just live in constant pain, I’ve been taking anabiotic’s for five years and pain pills which only help occasionally. I believe in God and that he heals, Yet all the prayers, huge amount of vitamins and supplements haven’t healed me yet. If anybody can help me , maybe there is a missing link that would be helpful to me. Please pray for me if you’re a believer. Thank you 🙏
Hi Marie. Yes persistent infection is rare but a very difficult thing to cure. We wish you the best of luck but often further surgery is required.
How are you doing now?
How are you doing today?
I hope you are doing okay. I had a tenacious infection after a THR and ended up having a girdlestone procedure. It wasnt the outcome we wanted after 6 months of surgeries and antibiotics. Without being melodramatic it becomes a choice between living with mobility issues and dying - the infection will only get worse. Living or dying - it is that serious.
Were you allergic to the previous materials? Do you have auto immune issues?
This is terrible and makes me not want to get the surgery.
I’m so sorry . I will pray for you.
I've just been told i have a deep infection in my knee replacement which was done 5 years ago, all that time i'v had a stiff leg and suffer daily pain, my first surgeon said there was nothing he could do, know 2 different surgeons tell me it's so bad i should have the 3 stage procedure, so i'm so glad i saw your video, i believe it will be a long process and recovery, i'm 79 years old, they are setting up for the operation to be in a few weeks, so hopefully it goes well.
Glad I found this video, explains a lot, had my left knee replaced in April of 2019, I have had 5 surgeries to replace my knee cap and I & D’S, my last I and d was a week ago, dr took biopsy deep down came back positive will be have a two stage removal and replacement surgery. I have been living in hell with this knee replacement for six months, praying this two stage will get rid of infection..
Hi Jessica. Wow, sounds like a long road. Yes a two stage revision gives you the highest chance of curing the infection once and for all and getting to move on. Best of luck and keep us posted. Thanks for watching
Hi Jessica, I'm sorry you are going through this. I was considering a right TKA, the surgeon scared me with all this infection stuff saying if this happens my only option would be a fusion or amputation. I desire a replacement so much. I don't know what to do because it could be a successful surgery he said its like playing Russian roulette & It would be like playing with fire it could go either way.He would have done a 2 stage. This is a very hard decision.
MzMysterious2 U since going through all this, after they put new hardware back in if it does get infected again, I will probably amputate, with the spacer in you can never really get comfortable, I have to wear a brace to sleep in so I can get comfortable, get a second opinion about surgery, yes there are risks, but I took those risks, 7 surgeries in 7 months, but as with any surgery you have risks. The same dr did my other knee and my left hip and had no problems. Best of luck to you.
Why is it necessary to do two stages verses giving intravenous antibiotics for a couple of weeks and then do a revesion instead of putting the patient through two procedures
Well I wish I could say that I had success with this knee but after having it replaced again, it filled with fluid, twice, I see a surgeon on Monday October 5 to discuss amputation, it’s either that or never walk again and spend my life in a wheelchair, I’m a fighter, just don’t need multiple surgeries, my body wouldn’t handle it..plus there are no guarantees, I know amputation is extreme but my best option right now..
Really informative - my "new" surgeon did some blood work, and they did an aspiration today. I got more from this thann anything else - thanks guys.
You are very welcome. Hope everything works out. Thanks for watching and subscribing
Well it’s been since 2019 since I had the infection, and ha that cleared up an then he surgery for the bar put in my knee. So I just got appointments for Pre-Op Dec 2 and hopefully surgery will be done his time. What a Christmas present that I’ll be.
Thanks for your videos they have helped me through this. Darlene. Yes it is a long and arduous process!
Nice Darlene! It certainly has been a long wait for you. Good luck. Thanks for watching, subscribing and sharing with someone if you did.
The infection creates a biofilm that attaches to the implant. Even with ID & D, you more than likely won’t wash away all of the infection.
I contracted Strep-B and had a full blown TKR infection 3 weeks post-op. Just enough time after the two-weeks of post-op antibiotics prescribed by my surgeon, and one week later a bursting open of my surgical site. I was shaking violently, had a high fever, and I could only move my leg about 2 inches at a step exclaiming “oh, God”! with each step. To say I was terrified is an understatement. ER took me into a room in the afternoon, took my history, then someone from orthopedics came to get a fluid sample of my knee around 4 hours later. I was in agony, but knew that I was in the best place to find out what’s going on. No pain meds were given until after a culture had begun, and a plan of action was in place. I was going to be opened up again, be assessed by a surgeon, ID & D, and possibly the soft plastic “cartilage” and behind the kneecap would be replaced, if necessary, or, worst case the entire knee replacement components removed, I would be sewn up, and antibiotics prescribed. The following morning I was wheeled into OR, dry-heaving, violently sick, in pain and scared. I thought I was going to die. Finally, the surgeon seeing me, gave me something to calm my nerves, and he said, “We’re going to take great care of you”. This wasn’t my surgeon, but I felt I was in good hands.
Thankfully, I only had the ID & D flush out, and once the culture of the bacteria was identified, vancomycin was given to me for 3 days in the hospital. My original surgeon came to see my post-op, and he said that the reason why I contracted Strep Group-B was because I was overweight. I wanted to throw my water bottle at him. I felt like I almost died, and he’s callous, saying “You were my first infected patient”. I found out that Stanford, at that time, had a post-op infection rate of 3%. Well, basic math says that’s 3 out of every 100 surgeries get infected. It sucks if you’re one of the three that get infected. Stanford infectious Diseases told me that (the infection) wasn’t their fault because Strep Group-B normally occurs on the body. It was an eColi infection, and I never spread fecal matter on my skin. I never saw my original surgeon again, and only followed up with the surgeon who did my ID and D for post-op care and doctor visits.
Before being discharged, a PICC line was inserted in my chest, and I gave myself injections twice a day for 6 weeks. It took me over a year to feel like I could rely on my TKR after this event.
Before going into any OR, ask your surgeon for their infection rates. Wash your towels, bed linens, clothes so that everything that touches your skin is clean. Good luck!
Love your videos! Incredibly informative!
I have had severe infection after total reverse shoulder replacement. I have had 4 surgeries, original surgery, debridement and cleaning with IV Vancomycin and another oral antibiotic, then replacement shoulder was removed and replaced with antibiotic spacer with more IV Vancomycin and Zyvox and another Pikk line. I finally received my complete new shoulder in Feb 2023. I am now finally receiving Outpatient Physical therapy this month May 2023. I have had a very long recovery after 4 surgeries, 2 different hospitals with 2 different Surgeons and many Skilled Nursing Facilities plus Rehabilitation centers.
Thank you for explaining the process. My infections; MRSA, Staph plus an Abscess after being sent home for Home Care.
Infection is devastating for all involved. Best of luck during your recovery
This happened to my husband, he was very sick, was in the hospital for six weeks with getting the hip replacement removed and packed with antibiotics. Now he can’t walk and needs the second hip replacement. This isn’t as simple easy to diagnose as they are telling you. Because of this, be careful don’t take this risk unless it’s absolutely necessary.
Hi Teaser. So sorry to hear about your husband. We certainly did not mean to imply that this was a simple problem. There is a specific algorithm to help rule out infection and once diagnosed it is a very complicated problem for sure. Best of luck going forward. Stay safe. Thanks for watching and subscribing if you did.
I had an infection after a Quad Tendon Surgery and indeed every test they did on my knee came back negative. But when they finally did the Arthro Cleanout - it took 13 - 3 liter bags of cleanout fluid and i went through two months of Antibiotic infusions (At $250 copay PER DAY) and I am still on antibiotics 6 months later.
Hi, I am doing some research for a loved one who had a total shoulder replacement due to occupational injury as an Operating Engineer, using heavy equipment 12 hours a day for many years. He was advised after seeing a couple of Orthopedic Surgeons and tests, that he would need a total shoulder replacement. He put It off, as he is a hard worker, and pushed through the pain with ibuprofen and Tylenol. Finally it became to difficult to bear. He couldn’t sleep and the otc meds were no longer taking the edge off. He scheduled the surgery and had the total shoulder replacement. He worked with therapy and did his home therapy as prescribed. He continued to have pain, and therapy was not improving his range of motion. His therapists had indicated that there seems to be something not right, as your improvement should be coming along further at this point. They informed the surgeon, at the same facility where he had the replacement that they thought there might be something wrong. He also saw his primary physician who told him that the Surgeon needs to see him; and made a personal call to him, and the Surgeon had simply said that he should continue with therapy, and ordered a “work hardening” therapy. The Therapists actually did not follow through with this as they knew he was doing therapy and after 3 or more months, he actually began to lose range. So my friend saw the Surgeon again, and without doing any tests or looking into why he wasn’t getting better, told him that he was releasing him from his care, and no longer needed to see him. My friend continued with Therapy for a month or so, however the Therapist said that the therapy was doing no good, and he should discontinue it, and he may need it in the future. So my friend went to get a second opinion; as he wasn’t getting any help from his Orthopedic Surgeon, and he saw another Orthopedic Surgeon, out of the area, who indicated that he would do three tests, prior to making a decision. They did the aspiration, the ultrasound with contrast, as well as the MRI, and waited to find the results of those tests. Upon the test results, there was an infection, within the actual implant, the cement, and the overall area of his shoulder. He is planning on doing the 2 stage surgery, as per the second Surgeon. Why wouldn’t the initial surgeon have done any of these tests? Why would he dismiss him from his care? He has to have all removed and a spacer placed and 6 weeks of IV antibiotics. Then back in for the final replacement. He had no signs of infection, other than some nighttime sweats. Increased pain and very little range of motion, in his right arm. I can’t believe that any Orthopedic Surgeon would not look into this further, and at least listen to the patient and his own Therapists recommendation. Have you seen this before? Is it something to do with the Surgeon’s reputation that is at stake ? I am very saddened about this event, that has shattered his life for the last year! He has apparently had the infection since the surgery of August 2020. He was reluctant to have the first surgery, and now Is very apprehensive. Any suggestions? Thank you.
Hi Tammie. So sorry to hear about your friend. Not sure why those tests would not have been done sooner. This is why we advocate for second opinions if you are unsure. Often it does require the 2 stage surgery to cure implant infections. Best of luck to your friend. Thanks for watching, subscribing and sharing with someone if you did
@@TalkingWithDocs Thank You!
Ten weeks after Left TKR Surgery, pain and swelling woke me from my sleep, I was shaking and had fever and needed cane to walk. Next morning saw my surgeon, he did aspirations and x-ray to confirm it was a sepsis-type infection. Surgery was scheduled that afternoon. First I was started on antibiotics, then surgery. Surgeon cleaned out the knee, replaced all the plastic parts of the joint and placed antibiotics beads inside the opening, then closed the opening. I stayed in hospital for 6 days waiting for the lab to grow the infection in a dish to learned what type of infection I had. After being released from hospital I had an appointment with an infectious disease specialist and prescribed two antibiotics 1) Rifampin and 2) Doxy. Took both antibiotics for 6 MONTHS, had monthly blood draws and monthly appointments to monitor vitals. I lived. It was an ordeal. It was very scary because none of the doctors guaranteed success, but treatment worked and my CRP levels went down from 16 back to normal. That was last summer, this summer I broke my ankle now I have a cast. A broken ankle is nothing compared to a septic knee. LOL.
Hi Barbara. Glad you are ok. It is a big deal getting an infected total knee replacement. Best of luck. Thanks for watching and subscribing
I had an infection in my left knee which I had a total knee replacement. The doctor said that I needed surgery immediately so they took the total knee replacement out and put a cement spacer embedded with antibiotic. After that I went to a nursing home and had IV antibiotics for every day for 6 weeks then went home for 8 weeks on antibiotics. After 14 weeks I had surgery again to put in a new total knee replacement.
Hope it all worked out.
@@TalkingWithDocs well I am still having problems with my knee 3 yrs after the total knee replacement surgery. My knee is still really stiff and it’s been kinda painful again. My pain doctor did a RFA a 10 months ago and she said that she will repeat it February 2024!
Thanks Dr. Paul Zalzal and Dr. Brad Weening!!
Very welcome Alida. Thanks for watching and subscribing
My 72 year old MOM is going thru this!!! Praying the wash out works to avoid TK revision. Only time will TELL!🙏🏾🙏🏾🙏🏾
This is HELL on EARTH😢😢
Best of luck to her. Thanks for watching and subscribing
Praying for you all I'm trying to get mine done but can't keep having UTI.. Praying for you all God bless and help the doctors come up with a miracle For guys that stay sick .God bless 💓
Hello Doctors! I am going to need a hip replacement soon. The surgeon I talked to strongly recommended one hospital over a different hospital to perform the surgery stating that one has less chance for infection than the other. Is there any way for me to verify this?
I love listening to you guys. Been enjoying your videos for two or three years. I had a knee replacement 6 years ago and it went well.
I took Cefamandole I.V. for 4 weeks in 1984. After one year I had a butress plate un-screwed from my Tibia.
A lab test proved positive for Strep in the joint. My proposed 4-6 hour procedure took 34 hours.
IThe surgeons put my leg back together with a twist in it. The fix is why the operation took so long.
Wow Mark that is a crazy story. Thanks for watching and subscribing
I cancelled my Netflix subscription and now spend my time watching Talking With Docs.
Ha that is awesome anitazuck. Thanks for watching and subscribing
Close to 6/7 months out from the reverse shoulder surgery, the joint got infected. At this time I have drainage from the scar. No pain or illness at this time. In 4 weeks from 4/2, Doctor going to do the 2-step procedure. The sick part of this is I didn't do anything, pretty much baby the shoulder. Went from an active guy to a nonactive guy for the past 7 months, Never smoked, and stopped drinking for the past few months. Just a big SMH
So sorry to hear this Jim. Hope it gets better
I’m glad I found this video to show my dad and be able to relate and know that others have gone through what he’s going through! He’s had four surgeries so far TKR , after first surgery he went through two “wash out” surgeries and fourth surgery was when doc finally decided it was time to remove the replacement and place in an antibiotic spacer . He’s on week 3 of pic line antibiotics with less drainage every day . Surgeon follow up said 6 to 8 weeks to make sure infection is gone but now wants to take his time to do the final replacement again. He’s staying at a wound care facility but they say rehab might be an option after 3rd week ? Is this true ? Is rehab facility stay recommended or absolutely necessary ?? My poor dad just wants to come home and relax in his own bed .
Hi Ana. Sorry to hear about your dad. All cases are different so there may be a specific concern the doctors have for the rehab hospital. Hope things continue to improve for him. All the best. Thanks for watching, subscribing and sharing with someone if you did.
Hi Ana, sorry to hear about your Dad! Is he doing okay? My 72 year old Mom is going thru this. Week 2 post washout and antibiotics via PICC line. Praying the washout works because this is debilitating and hard on her body.
L
I've just had an infected high tibial osteotomy wound & on the mend after a wash out, debridement and 5 days of I.V antibiotics. All the symptoms discussed were present. What I found made it worse was the cauterizing of the wound with silver nitrate. The symptoms accelerated quickly following that treatment
Hi Rob. Sorry to hear that. Sometimes using the silver nitrate can dry up troublesome wounds. Good luck during your recovery. Thanks for watching and subscribing if you did.
This helped me a lot to listen to this again. I am waiting for a revision on my knee. In July 2019 I went to the dentist to have some teeth taken out, there was a confusion about needing an antibiotic and They didn’t give me one and pulled the teeth anyway. I was having problems with my knee and leg before that and was supposed to see the surgeon in another County 4 hours away, I couldn’t get the doctor there because of forest fires. Anyway I had a horrible infection and almost died and that was in September. The local hospital removed the infected knee and put a spacer in and sent me to the surgeon 4 hours away. He broke his Clavicle and I was up there getting better and stronger but came home in January,. Still kneeless, I finally was referred to a doctor here in April when Covid started and have had to wait and surgery was supposed to be done on May 26, My A1C was too high and delayed again so just trying to get information on how it will be done when ever that happen. Thank you for all your information. I have learned a lot. Thanks again Docs.
Glad we could help Darlene. Best of luck to you and thanks for watching.
Talking With Docs I have another question, sorry to be a bother, but , Hypothetically if you had a patient come in to you with an infected knee because of other surgery in the body where antibiotics were not given, and you removed the patients knee, put an antibiotic spacer in the knee and waited a year. Would that patient still be infected to not be able to have a new prosthetic knee yet? Or does that patient have to have to go to the dentist again first. If there are isn’t any sign of infection couldn’t the surgery be done? Thank you?
I hope you two gentlemen have a great holiday season and stay safe....
Thanks so much Kevin. You too! Thanks for watching and subscribing if you did.
i appreciated your video and the information provided. i'm staring at knee replacements for both knees at some point as i am currently bone on bone in each knee. the five points you made in the video all make good sense. i have a tendency to over do so i've learned to ask what my limitations post-op will be so i am conscientious not to do too much and set myself back.i will do one knee at a time. i had an anterior total hip arthroplasty two years ago. thankfully, it was hardly a blip on my radar. walking was my only required PT aside from some home ROM and strengthening exercises. i was diligent with all of that and my hip is doing great! i understand fully that knee replacement is a slower road to recovery so i'm trying to mentally prepare myself to stay motivated but be patient with the progress. i'm also all about the "prehab" as well! thank you again for the video.
You are very welcome
Hi Docs, My first surgery is Friday, they will take out the spacer and put in the rod from femur to tibia with antibiotics and be in there for a few months. Thanks so much for all your information.
Best of luck to you tomorrow Darlene. Keep us posted.
@@TalkingWithDocs I sure will! Thank you so much!
Hello --Tom Lovinggood here again from the states. After having done some research into knee surgery, l have learned that there are many brands of the actual components used in the surgery, Stryker, Bio-Met, Smith and Nephew, Don Joy etc. Could you do a video on all different protheses, with pros and cons? Which manufacturer do you use in your practice and why?
Hi Tom. There are many different companies but the principles of each are all very similar. All knee replacement have metal femoral and tibial components separated by a plastic liner. Some are cemented. Some are cementless. In Canada we typically use the one that we are most comfortable with as well as what the hospital agrees to provide. Socialized medicine is a little different but all of the big manufacturers are comparable. Good question. Thanks for watching and subscribing if you did
I just had to postpone/cancel my surgery because I tested positive for nickel. My implant was a Dupuy implant made up of cobalt chromium with a little bit of nickel. The surgeon is referring me to a different surgeon at a different hospital that does revision surgery. I’m hoping and praying that he has an implant that is more conducive for my body and I’ll be able to have the surgery. I’m bummed but relieved, too.
Hi Christine. For many that allergy is not significant however many companies - Zimmer Biomet and Smith and Nephew for sure - have other implant choices without nickel. Best of luck smith-nephew.com/en-us/health-care-professionals/products/orthopaedics/oxinium
www.zimmerbiomet.com/content/dam/zimmer-biomet/medical-professionals/knee/persona-knee-system/2932.2-GLBL-en-Persona-Ti-Nidium_Knee-Brochure.pdf
I recently had a shoulder joint infection on a virgin shoulder. MRI revealed a torn cuff and upon further examination the doctor took a sample of fluid and it came out green instead of clear.
72 hrs later I was in emergency surgery to flush the joint filled by 1 month of antibiotics Iv and 3 weeks of oral antibiotics.
My question is, I need tkr on both knees, what is the timeline that I need to wait before I can get them done.
Can UTI's lasting over a month without antibiotics cause prosthetic joint infection ? My mother is suffering from UTI for over a month. And now she started culture directed antibiotics. Can it cause infection ?
My brother had a hip replacement last May. In December he had an infection, they went in and did a wash. He had a picc line in and had daily antibiotics for 6 weeks. He seemed to get better and then a week ago, (end of March) , the infection came back. They removed the parts and put in some cement beads. That was a week ago. He has been getting antibiotics. Today, one week after the removal, a CT scan showed pus in the area again and a very elevated WBC. Now, they’re not sure what will happen next.
Hi Jan. Infections can be hard to cure. Wash out is often a first step and then removal with insertion of beads. Some patients will require repeat washout and new beads. There can be little pockets that are hard to get to. Best of luck to your brother. Thanks for watching, subscribing and sharing if you did.
Thank you Doctors
Very welcome Rita. Thanks for watching, subscribing and sharing with someone if you did.
My moms hip infection has been so bad for 2 months now, she’s hallucinating badly swollen 4x her normal size in arms and hands, eyes very yellow, staring into space for days now and all the doctors are doing are antibiotics and a flush but you guys just said a flush won’t do much past a certain amount of time she’s on day 60 of bad hip infection and only getting worse I’m worried her hospital in Springdale, Arkansas is going to kill her by not knowing what to properly do I’m praying the infection goes away. Today I’m going to mention cement hip
Hi Sean. For us if the washout and IV antibiotics don’t work, we remove the old hip and replace it with a new one often with cement that has antibiotics
I had a RT Knee total replacement, 3 to 4 weeks later was tested with a knee joint fluid draw and came up MRSA. So The infectious DR. said it was a deep joint infection. So the Ortho DR washed out knee and closed it back up. Went on Vanco for 2 times a day through pic line for 8 weeks, finally the numbers came down to go off Vanco to pills. 3 weeks later my knee blew up and got very hot! Went to ER MRSA is back and none of the Vanco or pills worked anymore. Went to another DR and sat on the table and he freaked out how bad I was. He sent me straight to the hospital for surgery to remove the knee joint and put in the anti bacteria block in to "nuke" the knee joint. Had that in for I think it was 2 months then went back to the DR and he said your numbers aren't coming down. You have 2 options leave the block in for the rest of your life or Amputate the leg. Well I chose amputation for the reason I just had a daughter and wanted to play with her with out anything slowing me down. I already lost 2 1/2 years laying in beds and hospitals. Moral of the story is "Make sure they take that knee joint out if you get infected". Take care
Hi Todd. Thanks for sharing what sounds like a very difficult journey. Infection is always a concern and amputation is the end treatment for an infection that cannot be cured. Good luck to you going forward. Thanks for watching.
Hi Todd, So sorry for what you've gone through. If you'd be willing, I'd like to hear more - we're developing a treatment for Knee joint infections. See this recent article about our efforts:medicine.buffalo.edu/news_and_events/news/2019/12/garwood-ehrensberger-campagnari-10629.html You can reach me at wbacon@garwoodmedical.com Kind regards, Wayne Bacon, President
Hello Todd I'm really sorry you've had such a rough time. I hope you are enjoying your little one and that being a great daddy to her makes up for all you've suffered! Blessings from Vera in Northern Ireland
Dr. Z,,,,, you were not your usual self.. hope this is not because this video hit close to home...
Hi Pete. Any surgeon that does enough cases will have infected patients. Probably less humorous because it is a more serious topic. And it’s an older video. Thanks for watching and subscribing
@@TalkingWithDocs I don't understand why you and every other surgeon downplays the amount of people who get infected after surgery. The "1%" given is flat out wrong. My guess is that the number is at least 10%. But hey, I really do understand why the 1% if used. It makes the patient think that he/she is the problem, and not the surgeon. I suppose it also makes people more willing to get the surgery because a 1% risk seems so low. A little story- I had an IUD many years ago, and I had bad cramps. The instructional insert claimed that the percentage of people who experienced cramps was less than 1%. I belonged to a female organization and asked a few of the women how many of them used an IUD and had cramps. ALL six of the women who answered yes to using an IUD also had major cramping. I see that the medical field still needs to work on a pill that cures dishonesty.
@@woofer13I’m concerned with this myself. Of course when you think of all the people getting surgeries, 1% is actually a lot! But I believe it’s higher than what we’re being told.
I had my hip replacement oct 2018, it was fine for 3 months but then the pain started, it’s been like this since, it’s not gotten easier or worse I don’t think, I’m still walking with a cane & a limp, I have to lift the leg into bed or the car and I’m over it, iv been having hydrotherapy and my therapist seems to think it could be the psoas tendon ??? ... I finally saw a specialist yesterday, he said the X-ray & ultrasound seemed fine & iv another appointment in 3 weeks where iv gotta have bloods done 3 days before, then iv gotta have a bone scan & then MRI ... I’m praying for an easy fix 🙏🙏🙏
Hi tillytrotter62. So it is obviously difficult to say without reviewing your imaging and examining you. Good news is that subsidence and fracture are ruled out with the xray. Bloodwork to rule out infection. Hopefully just soft tissue that can improve with time. Good luck and thanks for watching
The orthopedist doctor told me that I need to perform a two-stage revision because a bacterium was found in my prosthetic knee. In three days I will need to do this operation.
Hi Brain power. This happens sometimes. It is a successful approach with approximately 90 percent cure rate. Best of luck. Thanks for watching and subscribing
Hi Doctors. I was hurt at work last year with a hematoma on my left leg which broke down and I contracted MRSA. I had both knees replaced years ago due to RA. The infection destroyed my left knee replacement and I've been fighting this infection for over a year. After 4 surgeries I now have an intramedullary rod all the way through my left leg with a permanent spacer. I have no patella tendon due to everything which is why I now have a rod and can no longer bend my leg or will I ever again. Infections in joint replacements are really serious!
Wow Christine. That is so difficult. Infections are very serious and probably our biggest fear as surgeons because A lot of it is out of our control. Wishing you all the best. Thanks for watching and subscribing if you did
Thank you love all your videos!
I have bone on bone impingement otherwise a healthy lean male - after watching this video and reading the comments I think I will buy a set of crutches and play it safe 😅
See how it goes. Thankfully this is uncommon
Thanks for the information
I had 2 THR SURGERY N 1 YR LATER IM IM CHRONIC PAIN HIPS IM GOING TO HAVE A VERY LONG TALK WITH MY ORTHOPEDIC DR
ASAP
Hi Richard. Sorry to hear that. Best of luck going forward. Thanks for watching, subscribing and sharing with someone if you did.
Sirs, what is the infection rate for TKR in your practice? I’m on the road to a knee replacement in the next few months so I am doing research and physician analysis. I’m going to look for your video on the patients role in infection prevention. Thanks for the great videos! Stay safe!
Hi Mark 007. So the majority of centers would report a rate of infection of about 1% but this varies with patient risk factors primarily. Good luck to you with your surgery. Thanks for watching and subscribing if you did.
Mayo Clinic study reports 2% on knees, 1% for hips. I've been studying the subject for months. I had an infected hip 4 years after the original implant surgery. In the revision process now.
I had a total hip replacement done Feb 26th and for the last few weeks a rash has developed on my buttocks and hip area but my incision is anterior and has no discharge so my surgeon dismissed infection without any testing. It's painful and still there after a month
Hi Liz. Sorry for delay. A rash would be a rare sign of an infection. Hope it all worked out. Thanks for watching and subscribing if you did.
Hi! My mom had the bipolar hip replacement 6 years ago. Now she is in a lot of pain in around the groin area, and the ESR & CRP have been fluctuating for over 3 months. She’s been having fever & chills at the early onset. Last week the doctor ordered pet scan & fluid aspiration, and the result came back positive on bacterial infection of Staph.Aerus. The doctor strongly in favor of two stage revision surgery with IV antibiotic treatments. Is this the best procedure for PJI? What are the chances of recurrence infection after two stage revision? I read some articles about new treatment for PJI, including: DAIR, combination of Antibiotics, monoclonal antibody, etc. Your reply certainly will help us to make a good decision.. Thanks so much!
Hi Victor. So sorry to hear that your mother has an infection. It is very uncommon but does happen and sometimes in a delayed fashion. The only proven way to get rid of this infection is to remove the implants and put new ones in. This is sometimes done in one stage but often in two stages. This is a proven way to treat this kind of infection and then post operative IV antibiotics for 6-12 weeks after the surgery. Sounds like your surgeons have a good plan. Best of luck to you and your mother. Please keep us posted on your decision and her progress. Thanks for watching.
Hi. I had a total hip replacement surgery 2years ago, then after 6 to 8 months i started having some pain on the hip.. when i went to the hospital i was told the implant was infected and they're planning to do DEEP TISSUE CULTURE AND JOINT WASH. Any advice for me please 🙏🙏🙏
I’m so glad I found you two. The information is greatly appreciated. My question is : I’m having my left knee replaced and I have a high bed. Do you have suggestions on how I can get my leg up more easily?
Thank you. Linda Jennings
Hi Linda. Some people hook it with the other leg. Some people use a belt as a hoist. You got this! Thanks for watching and subscribing if you did
You will have to go to physical therapy after surgery and the therapist can teach you how to lift your surgery leg with the foot of your non-surgery leg by hooking.
Thanks for this informative clip. My mother (now 84) had a double knee replacement some 7 years ago. One of them has recently become infected and the treatment is, as I understand now, a 2 stage revision. My question is, has the chance of the other knee becoming infected increased? Regards, Stephen.
Hi cleanheadcole. Theoretically there is a chance of both knees becoming infected. The issue is that if there is an infection somewhere else in the body that can lead to bacteria in the bloodstream and subsequently seeding of the artificial joint. If she is on antibiotics throughout her 2 stage revision the odds are much lower. Hope that helps. Good luck to your mom.
Thank you.
Very welcome.
cleanheadcole please watch over your mom my mother is so sick now
Sir what is your email id, i want to share my Case
Was recently diagnosed w infection in left hip after total replacement. Had exrtreme pain walking after surgery esp as wound healed. Hurt to move/lift leg. ESR, CRP and I-6 came back high. Fluoroscope aspiration and US Aspriation were dry. Bone scan was inconclusive for infection/loosening. Im still shocked it became infected. I had a high BMI at time of surger (39ish) and no diabetes. One clinic dis ESR/CRP and FS aspiration. Second did ESR/CRP/IL-6 and US aspiration. I am still in shock and grief over this but after 2 clinics get same results and conclusion I guess thats it. Strange thing to me is hip hurts same as before surgery. Thanks for video. I'd like to see a video and explaination of the 2 stage procedure. Im pretty scared of what happens next.
Hi Dave. Sorry to hear this. Half of aspirations are negative even though infected. The first stage is removal of old parts and insertion of temporary cemented parts. Second stage 3 months later when infection is confirmed to be cured and new parts put in. Best of luck. Thanks for watching and subscribing
@@TalkingWithDocs awesome. Thanks for the reply. So after 6 weeks of IV antibiotics I still have to wait 6 more weeks for stage 2? Also i had anterior repllacment - is the revision usually the same path into the joint? You guys rock!
Thank you for the informative video. I was hoping for an opinion. I had right side THR and am in my 11th week. Pain levels were low by the 2nd week post op. By week 7 I was walking some without the cane. The same week, pain came back quite a bit. I'm now using a cane again. My doctor said the x-ray looks fine and said I was trying to do too much too quickly. He stopped PT and told me to take it easy and I'm on 800 mg ibuprofen 3 times a day. No fever or swelling, etc. He said hopefully it's not an infection. I am not scheduled to see him again until week 15. I still have some groin pain, buttock pain and some pain on outer hip. There's a numb area between the incision and outer hip. Also a random, slight tingling sensation on my outer shin that comes and goes. I'm not sure what to think about this. Any advice?
How are you now??
How can you prevent getting an infection long after your total knee replacement? I thought whenever it healed I'd be in the clear.
Hi Vee. The problem is if bacteria enters your blood from another site like your lungs or bladder or wherever. Then the bacteria can seed the implant and lead to an infection. Best advice is to try and not get an infection elsewhere. Hope that helps. Thanks for watching, subscribing and sharing with someone if you did.
@@TalkingWithDocs I'm asthmatic and very prone to chest infections and pneumonia and have had septicemia since treatments for breast cancer and I never knew I should have antibiotics before dental treatments! I think my system is totally banjaxed as I'm allergic to penicillin and several other antibiotics which means I have to stay in and have iv antibiotics. I haven't had my other knee done because of the pandemic so am learning from your videos how to cope with pain. Wish I'd known when I was a primary teacher not to kneel or squat so much beside my little ones! Thanks for the great info on your channel .....everyone should learn this stuff about their own bodies from infancy so they'd know how to look after themselves.vera
my mother had knee done in september my poor mother was on ventilator for 2 weeks now tracheotomy she is 71 the doctor her blood pressure is now a little decent soon she will have a gtube shes on multiple antibiotics my mom had it washed now she has a spacer surgery back to back my mom is so sick im so worried about her she only wanted to walk better I may lose my mom because of a knee replacement i feel horrible i let her do this
Pices-lady, I wish your mother well. Look after yourself so you can be there for her. Best wishes.
Hi Pisces-lady. It sounds like your mother has had a very difficult post operative course. Certainly there are risk associated with any surgical procedure regardless of how big or small it is. Infection is thankfully very uncommon however it is very serious and often requires multiple procedures to eradicate. It is often a difficult decision to regarding whether to proceed with knee replacement surgery as we age. We wish your mom the best in her recovery.
cleanheadcole thank u
Talking With Docs thank u very much
You are very welcome!
Hello Doctors
Thankyou for the information you provided
My grandfather got his knee replacement surgery done in November and 2 weeks later developed an infection
We then got it treated again and the infection was removed
Now again after 3 weeks he again has infection but luckily not having the severe pain he had the last time it was infected
So my question is, is it possible that with medication and physiotheraphy we are able to cure his infection and avoid the step of spacer and new transplant surgery?
Sorry to hear this. It is possible but a lower chance. Time will tell. Wishing him the best. Thanks for watching and subscribing
If you have infection in your knee and they replace it with the antibiotic spacer, How long do you have to wait before they remove the spacer and do the revised knee? Please! Thank you Docs.
Usually 6-12 weeks Darlene. Good question!
@@TalkingWithDocs well we sure missed that timing on this one didn’t we in this area. It was.September 9 2019. When they put this one in. It is still there. Circumstances got in the way. Heath problem, connections with doctors, Covid and long months waits for dental appointment for clearance,This year is going to be it! Yay! Then there will be two surgeries. I am already tired. :)
You two Docs really helped me through this with your great information! I am stronger and more educated and not worried just bored from not being able to drive. Thank you very much Docs!
Thank you!
@@TalkingWithDocsThanks Docs, good to know. It was September of 2019, it will be so nice to get a new prosthesis but they are going to put a rod in there first then the spacer, maybe I will have it by July: All is good. Take care Docs and thanks.
Hi Docs, I am still waiting. Keep up the good work out there.
I had a total hip replacement 4 months ago. My skin started breaking out right away and it's still broke out but not itching. They did blood work and my sed rate and cry rate were really high. I have alot of pain and on a walker. They did a punch biopsy on me and they sent me to the ER because they thought I had a blood clot. Now they have done another biopsy and I won't know for 1 week. I'm just so disgusted and hurting constantly. I've had 2 knee replacements with no problem.
Hi Linda. That seems odd. Your ESR and CRP will be elevated after surgery. Hard to know what the blisters are. Sometimes infection. Sometimes allergic reaction to the adhesive depending on how close to surgery. Best of luck. Thanks for watching and subscribing if you did
@@TalkingWithDocs my surgeon sent me an to a dermatologist and he took 2 different punch biopsy is. They came back that I had inflammation. He thought it might be arthritis but my primary won't give arthritis meds and getting into a Rheumatologist is impossible. My hands have been deformed and I've had 11 back surgeries. I know it's arthritis. HELP ME. I DON'T KNOW WHAT TO DO!!!!
Hello Doctors.
I had a total hip replacement May 22 last year. The incision wouldn't heal and there is recurring discharge. Though researching and diagnosis from a doctor, the hip is badly infected. I have been searching the internet eversince I had pain. Many sites and doctors proved that there is connection between tooth infection and prosthesis infection. Now I realized I've had unsettled unsuccessful root canal treatment. I've had this tooth fistula (abscessed tooth) for many years (probably around 15 years). Can that be the cause of the hip prostesis infection????
The doctor found that I have "Heavy Growth of Staphylococcus Aureus". Is it really impossible to cure/treat it with oral medications and a surgical revision is the only way to correct it??
I have been depressive and anxious since to undergo a surgical revision is more difficult, more painful, longer and more expensive.
Hi melchor. Yes tooth infections can lead to infected implants. And yes typically surgery is required to cure an infection related to an implant because the bacteria stick to the implant and it has to be removed. It is a big undertaking for sure however often the only definitive solution. This is a discussion you should have with your treating surgeon before surgery. Good luck.
Hello doc thank you for the response. My surgeon gave me a different type of antibiotic (which is intended for tuberculosis) for he said it kills both aerobic and anaerobic bacteria. The drainage on my hips is already 2 months. I wonder if antibiotics would totally eradicate the infection. Though I felt excruciating pain for 3 months before, I never had chills or fever as well as redness around the incision. I am really worried about my condition.
Can a UTI lead to a shoulder replacement infection
I lost my mother from sepsis last year. She had total knee replacement in year 2017. Dr couldn't find the source of infection
So sorry to hear that
All I could hear was pain, more pain, and more pain. Sounds way overwhelming!!!
Hi Cindy. It is very painful for sure. Thanks for watching and subscribing if you did
I had TKR in Jan. 2021. Went through PT and was back to playing golf, bowling, walking, gardening for 9 months. Then knee became infected. Had debridement, washout, replacement of plastic parts and 6 weeks of PICC line infusion of antibiotics. Five days after PICC line removed, infection returned, Nov. 2021. Have been on oral antibiotics, Keflex, since then along with 6 months of Rifampin which I no longer take. Rifampin was supposed to attack the biofilms exposing the bacteria to the Keflex. Currently I am back to golf, bowling, etc with knee discomfort but not real pain. Knee gets stiff from time to time. Is there any way to determine if the infection has been cured and I can stop the Keflex?? Surgeons don't want to stick needles in the knee to find out because of infection risk. Can I stay on Keflex indefinitely? So far it has caused no problems and I have been able to reduce the dosage by 1/3 with no effect on my knee. Thanks for your response.
So only way to know for sure is with a sample and tissue better than fluid. If you stop antibiotics that is often the best test. Usually don’t want lifelong antibiotics but that one is well tolerated. Best of luck
@@TalkingWithDocs If I stopped the antibiotics and infection flared up again would I be able to contain it again by restarting the antibiotics. I have been told that if the infection flares up again I would need to have the prosthesis removed and antibiotic cement installed and then new prosthesis. That is a long and painful process that I would like to avoid
@Cyril have 1 questions if take medication life time so never back infection again ?
@@cyrildraffen7512 i have one question if I take medicine for lifetime, so never back infection again??
Hi, Brad. This question is a follow -up to your video on why the knee still hurts, and one possibility was loosening of the components. How often does this really happen. Do you encounter this often? Once a week --once a month--once a year?
I presume that if one of the plates
becomes loose, you are forced to re-open the knee and re-cement the plates?
Thanks again.
Hi Tom. This is rare and is typically how total knees fail over time so more commonly 10 or 15 or 20 years after surgery. Thanks for watching and subscribing
There is a lawsuit over these knee implants... 60,000 people are suing... the implants were never safety tested. Just google.
I got a staph infection in my 4 year old knee replacement. Dr. took out the knee, did a washout, put in a temporary plastic knee replacement. He says I can keep it if it is working. Is that a good idea? Or should I go for the revision? I am 65 and pretty active.
I recently had an anterior hip replacement april 17th, no pain or sign of infection yet.,But i had a tinge of blood wiping with TP. twice a week after surgery , the Ortho's and PCP said nothing to worry about, BUT I've seen some British Ortho's say on you tube that it is a major cause of deep hip infections. BTW, My hemorroid was found by my PCP to be internal,following the wiping incident, But there was a slight tinge of blood wiping ,, Thoughts? Should I mentally get use to the possibity of a revision nightmare? thanks docs
That would be uncommon but not impossible. Watch our hemorrhoid video. Lots of water and fiber. Good luck
Thanks Doctor,
Foe making a such nice video,
I have done my ACL and PCL surgery 3 weeks back, I am getting fever 99.4 to 99.9 at night since 3 to 4 days, but I don't have any redness and severe pain in Knee.
Want to know that is there chance of infection . Why I am getting fever at night only.
Hi Mukesh. Hard to say. Could be related to your surgery. Can be related to your lungs. If you have ongoing concern should see your doctor. Best of luck. Thanks for watching and subscribing if you did
I've had a total right knee replacement, almost 5 years later, doc. Said my structure is fallen apart....need help figuring what are my options
Hi Jessie. Likely the only option is a revision. Good luck. Thanks for watching and subscribing if you did
Seeking for your informative opinion; what options do you think is available for an SCI, c5,c6 patient with
Left hip arthritis
Left knee arthritis and
Right hip fusion, fused to pelvic
A disturbing spasms
And has higher hopes of getting back to walking just that the complication mentioned seem like the obstacle in the way.
Wish to hear from you.
Thank you
So sorry to hear this. It would really depend on your spinal cord injury. A fusion can be converted to a hip replacement by someone with revision experience. It is a difficult procedure. See someone locally with a special interest in this area. Best of luck
@@TalkingWithDocs Thank you
Dr. My 84 yr old dad, has an infection with no bacteria found, he had heart and kidney problems, can he just get antibiotics for life...thank you
He had a TLKR 6 months ago
It really depends on his symptoms and the status of the knee replacement. Sometimes this is an option. You should watch our newer videos on this topic. Best of luck to your dad
Thanks for right kind of information at a right.time...I had my bi.lateral knee replacement on Dec 20 , 2021 and am now close to 5 months past the surgical procedure..
I had puss coming out of my stitches around 6 weeks post surgery and was put on Clindamycin and Linozolid, for extended 12 days...My doctor got very Happy when I told him that threads were coming out of skin...he said it was more of a superficial , suture line infection...hopefully I am saved off...
I.have started playing golf, with very minimal pain in my both knee. Howevr, my left knee is bit more warmer than right.. Can this be a cause of worry or what would be long term prospects...
Thanks as always
Hi lj. Sorry to hear this. The warmth can be normal. Usually pain and loss of motion are more common worrisome signs. Enjoy the links! Thanks for watching and subscribing
@@TalkingWithDocs thanks n many thanks
Do you all have a video sharing information if a TKA fails & some patients are left with a fusion or amputation? Thank you
Hi MzMysterious2 U. Thankfully we have not had that happen as an outcome thus far in our careers but it is a potential outcome particularly for severe bone loss or infection that can not be cured. Hope that helps.
Here you go; Rosie's story.
czcams.com/video/BQeC04q9Iis/video.html
Hi Dr. Can a 42 year old patient with a history of osteomyelitis 10 years ago get a knee replacement? I was in a horrible MVA 25 years ago. I have my normal ortho dr saying he would like to replace the knee for a better quality of life. My knee has been fused at 35 degrees for 25 years. A second opinion dr is not as confident. Reading one gentleman's story about MRSA & he had to amputate this is scary. I've waited to become of a decent age to be eligible for replacement. It would be a dream come true for me. What does it mean to leave a block in the nuke or amputation? Just curious as I read the other gentleman's story & him choosing to amputate. Thank you. Would like your thoughts on my question. Great video!
Hi MzMysterious2 U. Thanks for your question. It is a difficult one to answer. Yes your chance of an infection is higher than others however if you have not had any specific symptoms, it is not unreasonable to consider a total knee replacement. Good luck with your decision. And thanks for watching.
Why aren’t antibiotic spacers and cement used to begin with?
My dr in Utah Dr Gililland did my surgery in feb . Bilateral knees emergency surgery. Was told life or limb . I was 10 years out. I had had a blood draw in my power port and she did not clean it very well or use a good sterile technique. Scary but was told this can happen again
Best of luck to you Kimberly. Thanks for watching, subscribing and sharing with someone if you did.
A friend of mine told me that his friend had something like a "bug" or something that seemed to be, "eating away" at his hip joint. He is thinking about having surgery but isn't having much confidence in his doctors.
What is it that could be, "eating away" at his hip joints?
Hi Grizzly Addams. Not exactly sure what that means but you shouldn't have bugs in your hip. Maybe he has an infection? Or maybe he has avascular necrosis? Hard to know without seeing him as a patient. Hopefully he gets the care he needs. Best of luck and thanks for watching. And be safe!
My great uncle had three infected hip replacements. Each time it’s happened he would have to go to the hospital and have it removed. It’s caused to have trouble walking now.
Yes Shea this can happen and is a real problem. Thankfully very uncommon. Thanks for watching and subscribing
Wanted to let y’all know surgery went great. Now to get through these 6 weeks of antibiotics, then get replaced again.
Hi Jessica. That is great news! Yes 6 weeks of the IV antibiotics and then get the metal back in. Hang in there and good luck.
After getting my knee re-replaced in January 2020 my knee filled with fluid after doctor drained it filled right back up. So I am confined to a wheelchair and bed bound, will see a specialist in orthopedics. Good news not infected....
@@txtattooedlady whats your current condition?
Hello doctor.
My father age 59 years had total hip replacement surgery 2 years back inyear 2016 . Now he is feeling excruciating pain in his joint. Xray test clarifies that his artificial joint is in perfect shape and there is no infection in the artificial joint, as per Doctors examination who performed his hip replacement surgery. Sonography test states there is collection of fluid (12cc) superficial to the implant and medial to the rectus femoris and lateral to the common femoral vessels. We have started anitibiotics with name Acuclave 625 {Amoxycillin (500mg)+Clavulanic Acid (125mg)} for 10 days.
Will this resolve his condition? Also how would we identify that his infection has appeared to be cleared? What would be preventions to curtial further chances of such conditions!?
However, we are going with aspiration to understand what is the infection for better clarity.
Hi Divyesh. That is a complicated situation. The aspiration is a practical next step to confirm the infection and identify the organism. If the infection is deep to the joint replacement, it is possible that he would require an irrigation and debridement (washing of the joint ). If the infection persisted, the next step may require removal of the prosthesis and insertion of a cemented prosthesis with antibiotics and IV antibiotics after surgery. It will depend on what is found and how he responds to the antibiotics. Good luck and thanks for watching.
@@TalkingWithDocs
Dear Doctor,
Thans a lot for your reply.
What happens in such circumstances if you end up with the antibiotic spacer isn't taken out because the doctor left the area and Covid has messed with things. I have had mine in since Sept.2019.
Take care Docs glad your still on You Tube!
Hi Darlene. Some people keep the spacers but it usually is not possible to keep it forever. May need to find another surgeon. Good luck Darlene. Thanks for watching, subscribing and sharing with someone if you did
@@TalkingWithDocs Thanks Docs I have found the surgeon it’s the dentists who have been holding things up. I am going to be telemedicine my New surgeons office. on Weds to explain the situation too, my two friend are going to be with me when I see him.
I will let you know .
Now I have another question one since I am anticipating surgery. Do you have a video of how to prepare days ahead for surgery day?
Like antibiotics? How to prepare the area of the knee/leg skin. How many days before?
Thanks so much for your videos, makes me less nervous being prepared.
Have a wonderful day.
Hi Doctor, thankyou for all the information. I had a total reverse shoulder replacement six months ago. I developed an infection three months ago. The implant was removed, had two rinsed outs at different dates and replaced with an anti biotic cement implant with a plastic spacer. I received 6 weeks of IV antibiotics and are on oral antibiotics now for another 4 weeks. My surgeon suggested in three months to install a new metal implant. Stil some swelling and a constant pain of 2/10. I'm looking forward to the final implant. My question - will I have a permanent disability in the shoulder?
Hi TTEC. Hard to say but it is possible because of the amount of surgery you have had. Infections are very complicated. Multiple incisions, scar tissue, etc. Best of luck to you. Thanks for watching, subscribing and sharing with someone if you did.
I have a 33 year old reconstructed hip. It needs replacement. But as of now it has fluid in the joint. If I try to stand up straight I have pain going down my leg and up my back. Worst pain I've ever felt. Pain in the joint is the same. The leg has "fever" of its own......I just found this out 2 days ago and haven't seen an orthopedic yet.
Signed,
Worried
Hi grizzlybexar. It sounds like you may have a hip and a back issue. If your pain is getting worse you should probably start with xrays of both and definitely go and see your family doctor and then a surgeon if required. Hope that helps. Keep us posted and thanks for watching.
Sir my father gone through a knee replacement on 22 december 2019 from few weeks he is uncomfortable with his knee having pain stiffness and from few days the knee upper surface get swollen and soft like something is in the knee area any type of fluid
Sir what is the level of infection ?
Hi Ramesh. The most common cause for what you describe is a normal post operative course. If he is concerned that he has an infection, he should be assessed by his physician. Good luck and thanks for watching and for subscribing if you did.
Sir
My father diagonsed with infection and operated on 3 march
With debriment process and spacer change
Doctor said infection was from 15-20 days.
Is infection will occur again?
What your opinion on this.
I understand that statistics show that 1% of hip implants develop infections down the line at some time. My question is what is the percentage of that 1% having to go through another hip revision on the same hip due to another infection? My surgeon didn't give me a figure, but I'm doing well since my revision implant in July.
Hi Doug. Do you mean a revision for infection? If so, and if the infection was cured, it would be the same 1% or slightly higher. Thanks for watching, subscribing and sharing with someone if you did.
@@TalkingWithDocs Yes. Four years after original implant. March 2021 the implant removal. July 2021 new implant. My surgeon could only say he had never seen a second infection in 16 years after the two stage revision. I'm very worried because I don't think I could go through this process again at age 71? Thanks for your reply.
I wanted to have bouth my knees done but my heart doctor doesn't want me to have them done because my blood pressure is 205/174 without the knee done.if they could get the knee pain under control it might bring the blood pressure down,i wanting to have it done to get rid of all this pain,im scard to have my knee done because of my blood pressure being so high,so what to do ,i have UTI now, trying to get that over taking antibiotics, my knees are so painful my blood pressure is a problem 😅 so what can I do ,,
I had cement spacer and the pain is excruciating when I get up or sit down..is this normal?
A 60+ man who has had three hip replacements surgeries now has a chronic infection that has mutated and has caused necrosis in his toes. He has been told to date that the wash out and new hip replacement is no longer viable due to the lack of bone to support. He is now on antibiotics to address the mutated infection. However, are there any options to address the original infection and hip replacement issues? Thank YOU
Hi L Battle. So sorry to hear about the difficult situation that you are in. So if replacement is not an option, one option to cure the infection is to remove all of the metal - it is called a Girdlestone. It leaves you without a hip joint however there is potential that you could walk but would have a significant limp. Best of luck to you. Thanks for watching and subscribing if you did.
I had to artificial knees and had infection in one after a dentist appointment with out antibiotics. How come it didn't infect both knees?
Hard to say Darlene. It all relates to blood supply and your body's ability to fight off the infection. Good luck. Thanks for watching and subscribing if you did.
How sterile is the implant when it is put in ? What assurance is there that the implant does not already have bacteria on it ?
Second part of that: what if the patient just wants the implant taken out and cannot take any more pain. Would you then just fuse the bones together and there you go... a big ole' peg leg for the rest of your days. 😒
Hi Jenny. So sterile is sterile. You can’t get more sterile than that. So if the pain continues you wound want to know the cause before removing it. Sometimes fusion is an option but is not totally straightforward. Thanks for watching and subscribing
I had an infection in my knee as a result of a cortisone shot. Never had any surgery on that knee before but it has deteriorated at age 66. The doc wants to put a temp spacer with antibiotics in for two months as an added preventative for infection, then do a TKR. There’s not much on the internet for this situation, so i just wanted to ask if that would be the route you suggest. I’d rather forego the spacer and go right to the TKR. Thank you very much.
Hi bob. Sorry to hear about your infection. We have not heard of that strategy but it does vary between surgeons. Typically if we had a patient with an infection in a knee without an implant, that knee would be washed out emergently, samples would be taken followed by IV antibiotics guided by our infectious disease team. Once antibiotics were completed, we would take an aspiration from the knee to ensure there was no residual infection as well as bloodwork. We would also typically wait 1 year to do a knee replacement. Hope that helps. Best of luck to you. Thanks for watching and subscribing if you did.
What is the meaning of aspiration failed after tkr revision
Hi Anantha. Aspiration failed sometimes means that it was not possible to draw any fluid out of the knee. In what context? Thanks for watching and subscribing if you did.
Hey Docs What about an allergy to the hip,cobalt and nickel?
Hi lisa. True metal allergies are uncommon but possible. Best to be formally tested. If you are, there are some options for alternate materials. Thanks for watching and good luck.
I had a bone infection in my left knee and I had the 2 step replacement surgery that you were talking about. Now my knee constantly feels like it wants to collapse on me when I walk. Is that the bone infection again? My doctor said if I get another infection that he couldn’t fix my knee again and would have to amputate my leg!
Hi Gayle. So the loose feeling is typically not an infection however there can be instability after revision surgery. Best to get reassessed. And it can be very difficult to cure infections but if you do get another infection please see another revision expert before you commit to an amputation to discuss all possible options. Good luck Gayle.
Hi Doc.
I would love to find out if a person is paralysed and have and hip bone remove due to infection over 15 years at the beginning of being paralyzed and now desired to do a replacement if can it be done ...and what type of replacements would you advice to put in??... please and thanks for your advice.
Hi Dwain. So it would really depend on the type of infection and how much bone loss was caused at the time of the initial infection. The type of implant would typically be a regular hip replacement or possibly a revision type implant to address the bone loss. It is not always possible. Best to discuss with your treating surgeon. Thanks for watching, subscribing and sharing with someone if you did.
@@TalkingWithDocs Thank you Doc. To answer that bone loss quest is that little bone that connects from the hip socket to the FEMA... and it don't matter how long it as b3en out it can be replace right and in spite being paralyze ?? thanks again for replying.
I'm on my 4th static spacer. I was told my last option is a fusion? What's best live with a spacer or fusion? Lost , scared, confused.
Hi Donna. This is a complicated scenario. We often use articulating spacers that allow patients to walk and bend their knees. This seems to provide more function for patients. Every scenario is very different and it is something you should really discuss with your surgeon. Good luck with your decision going forward. Thanks for watching.
Hi Donna, in October, 2019 FDA granted "Breakthrough Device" designation to BioPrax™, our Implant Biofilm Infection Device and Treatment, which is under investigation for treatment of total knee bacterial biofilm infections. We would like to hear your story if you are willing - I'm so sorry you are going through this. See this recent article: medicine.buffalo.edu/news_and_events/news/2019/12/garwood-ehrensberger-campagnari-10629.html Consider contacting me: wbacon@garwoodmedical.com
@@TalkingWithDocs I was diagnosed @ May 2017 with OSTEOMYELITIS of my rt knee replacement. I went to everyone I heard were top in their field in Ga only to hear, " Just stay with Doxycyline HYCLATE B.I.D. & deal with your chronic sinus tract wound." I finally went to Mayo Clinic in Florida & one doctor advised only AMPUTATION & another Doctor suggested an Arthroplasty Resection of the affected rt knee. The second doctor said she'll try to save my leg by doing a resection with no spacer...permanent fusion! No other OPTIONS were given to me to pursue. Is this the ONLY approach for my problem? By the way, I also have LYMPHEDEMA in this lower rt extremity. Thanks for listening & hope to hear your ideas! Take care, Deborah
My husband just had a total hip replacement & just went thru a second operation to flush out a nasty infection in the joint they also replaced the ball & the cup ....Now he is facing intravenous antibiotic treatments which are very expensive...which we can't afford & his insurance won't cover ...what now ????
Hi jeweli coats. We are very sorry to heart that. Thankfully infections are uncommon but they definitely happen. Washing out the joint followed by intravenous antibiotics is the standard of care. We are not familiar with ways to help with affordability in other countries. We wish your husband a speedy recovery. Thanks for watching.
I have a wound at my knee ,it has been infected I got antibiotics for a couple wks but the nurse to a swab and when it came back they said the is a bug in the wound and antibiotics can’t be used I’ve been referred back to orthopaedic so they can have a look to fix ,should I be worried
Thanks
Charlie 🏴
Hi CharlieBoy. Hard to say. If antibiotics can’t be used may require a wash out. Wishing you our best. Thanks for watching and subscribing if you did
Hello
I have the same infected knee problem and have one more week of antibiotics making it 6 weeks. Then was told pick line comes out and wait three more weeks to check that infection is all gone. My blood scan looks very good now all my numbers have gone down, Question I still have one problem , I was wondering why my leg still turns pink to red from knee to my toes when i stand but it goes away when i lay down and elevate and its back to a normal flesh color . Is this going to go away or do have a circulation problem I have a static spacer not Articulate Leg Prosthetic. i was told to have no walking or pressure on Knee replacement leg have to use a wheel chair and walker . It has been a really terrible experience I feel like total handicap. I can only hope I can walk again and not loose my leg thank you
As we answered below, typically this will improve but it will be some time after your next operation as your muscles get stronger, your range of motion improves and you regain your ability to walk. Good luck.
Hello docs, this is my 6/7 weeks after total knee replacement. And I was stepping a single stone and then I slipped. But I didn't fall because my mother hugged me and controlled balance. But I stepped the ground with my surgery knee a bit.
I can feel numbness in my surgery knee for 1/2 days. And now I'm better and no pain.
Is there something I should care after this incident?
Hi Gip. If you are improving it’s probably ok. If concerned contact your surgeon. Good luck. Thanks for watching and subscribing
Hi Docs, can a bronchial infection migrate to a 4 month old hip replacement. Treated with a z pack, worry if it was enough.
Hi Kathleen. Unfortunately, there is always a possibility of the bacteria from your lung infection entering your bloodstream, and then subsequently going to your hip.
Had a partial and they did a revision 1 month later. It’s been a nightmare. The new surgeon thinks I have an infection
What happens if you don’t treat the infection? Trying to wait as long as possible to have my surgery. I have to save time off
The infection has to be treated or the parts will loosen, the knee will be stiff and you will have pain. So sorry this has happened. It can get better. Thanks for watching and subscribing
Sir I got knee replacement surgery done in June ,2019.A month ago I had severe pain in calf region and next day a lot of swelling, which gradually disappeared in two weeks.Now I have severe pain in front part of knee.
I don't remember if I had any infection since knee surgery.Xray is fine all tests are normal.
Please suggest me।
Hi Ajay. It is hard to say the exact cause. Best to get assessed. Consider a short course of physio, icing and possibly some medication. It would be uncommon to be an infection without any other signs. Thanks for watching and subscribing if you did.
Thanks sir, yesterday I got the scan done on advice of a nearby orthopaedic surgeon.
As per your advice I have started applying cold pack and I have a appointment with the surgeon who operated for tomorrow afternoon.🙏🙏🙏
Well doctor I got my joint removed in March and a new one with a ten cm rod.put on 29th May.So far it's all ok.I move around with a stick in hand 😂😂
My grandmother has a low grade infection. She had a femur bone replacement. And now it has been dislocated. As the operated doctor is saying she must have fell somewhere. But we referred to other doctors they are saying yes it's been dislocated as she all ready has Parkinson problem That's why due to muscle stiffness and anxiety attacks they have been dislocated. And now coming back to infection the doctor are saying there has been infection after a week or two week of the operation. And if it will be operated then it will be risky one or if we leave it now. Then the infection will spread all over the body internally. She is 78 years. The operation was done in September 2019. What will be your advice on that ? Please tell us.
Hi Shubham. It sounds like a very complicated case. If the hip has been dislocated for 6 months it will be very difficult to put in back in place. The main issue would be the infection and if this is the case, it would require either a one stage or two stage revision to treat the infection. Best to discuss with a surgeon that has experience in this area. Hope that helps. Thanks for watching, subscribing and sharing if you did.
Hi my mother had her hips replaces in 2004 and 2005. This year in March 1 got infected....5 weeks in hospital and 5 weeks revalidation. The hip was washed twice in hospital. She came home and everything went well. Last thursday the stopped taking antibiotics (took it for 8 weeks or so). Yesterday she got fever and now she is again in hospital. Doctors will wash hip for third time. Doctor said she has not much bone to replace hip (if neccessary). He said she may have to take antibiotics for rest of her life. Is he correct? Hope my english is fine..im from Holland.
Hi LM. Sorry this has happened to your mom. Sometimes patients will have lifelong suppression of the infection if that works. The only other solution is likely removing everything and putting in a temporary hip replacement that includes a lot of antibiotic cement to cure the infection. Best of luck to her. Thanks for watching, subscribing and sharing with someone if you did.
Hi- I have been looking for videos on fungal infections of TKR's, and not having much success. I know it is very rare, but does happen. I have been tested for bacterial infection (negative) but after 15 months still have stiffness, warmth and discomfort (knee is functional, ROM is good). Seeing my doctor next month. How about internal adhesions? I am prone to them, and wonder if those could produce the symptoms I am having. Thanks!!
Hi Katharine. So yes adhesions can cause warmth, swelling and stiffness. Infection can also cause this but usually is associated with pain. Often infectious disease specialists are recruited to help with the diagnosis if things do not seem straightforward. Good luck and thanks for watching.
Hi my mom was just diagnosed with positive colonies of candida albicans
Just want to know how
Did ure diagnosis go and how was it treated
@@246nado There was no definitive diagnosis, but infection was ruled out. The doctor thinks it is most likely scar tissue and has offered to do an arthroscopic clean-out but I have learned to live with the stiffness. At least warmth has gone away.
@@LangKatharine i am so glad to hear infection has been ruled out… praying for complete healing for you
Praying my mom also doesnt have any infections
Hello doctor, i had done ACL surgery and got infection and my cartilage and miniscus damaged. Doctor suggested me for TKR. is tkr safe for me?
Yes but there is a slightly higher risk of infection in light of your prior infection
I need a revision tka. I just had my tkr 6 months ago and have worse pain. A dr. Told me I have a failed kra
Hi Rita. Sometimes total joint replacements fail and there are many reasons for this. Infection is the number one cause of early failures but total knee replacements can fail early if the position of the implants changes. Good luck.
Could it be a fungal infection?