Post knee replacement infection

[Ihateslugs]

Apologies for the long post.

Has anyone acquired an infection in a knee replacement soon after surgery? I have just been diagnosed with one following a number of tests when I developed excruciating pain at 10 weeks post surgery at the back of my knee which affected weight bearing.

I am going to have an aspiration on Wednesday to extract some of the fluid to be tested in the lab to ascertain which type of bacteria it is and if is resistant to antibiotics or not. Then my consultant will beside on what needs to happen next. If the infection will respond well to antibiotics then I’ll have a one stage extraction ie my current implant will be taken out, the infected area cleaned and a new one put in straight away. If it’s a resistant strain ( apparently most likely) it will be a 2 stage extraction ie he will remove the current one then place a solid cement block which slowly releases antibiotics and also supports my knee until the infection clears when he can operate again to put in a new implant.

I am now incredibly anxious and panicking about how how I will cope after the surgery, especially the second option as I live alone and it might take a few months for the infection to clear. If he puts in an articulated cement block then I’ll be able to bend my leg a little but if it’s a solid block then my leg will not bend and stay straight. I’ll not be able to weight bearing with either option so will have to use a walking frame and only put my operated leg down on tip toe to balance while I hop with my good leg! This leg also had a replacement knee implant 10 months ago and is not yet fully healed.

I was hoping someone here had been through this situation, apparently only happens to 1% of implant surgeries, and can reassure me that it won’t be as bad as I imagine. Or maybe has supported someone through it.

I put off having my implants for over 10 years because I was so scared of the operation and something going wrong! Sod’s Law really!

I do live in a bungalow which should help with mobility and have a cleaner every two weeks but other than that my son lives over 100 miles away and his wife is expecting a very precious IVF baby soon, my daughter lives an hour away, has a 2 year old, a full time job involving frequent travel abroad and a partner who does not drive so my only support in my sister. She also works and manages to help get me to medical appointments by juggling her rota but she is a single mum of two young teenagers.

I guess I am looking for possible options, maybe arranging a carer to come in an hour a day to prepare meals, sorting laundry and helping me shower. I have a cleaner every 2 weeks but the toilet and high use areas will need daily cleaning with antiseptic because of infection risk. I’ll also be on intravenous antibiotics which will need administering in a sterile way and I won’t be able to do it because I have arthritis in my hands and some loss of vision in one eye which makes me very clumsy. Hopefully I’ll be able to get daily visits from the district nurse.

Or do I just forget about living at home until after my second operation and look for respite care at a nursing home?

Please advise and calm me down, I actually feel sick at the thought of what I’ll be going through for the next 4 to 6 months, I’m such a wimp!

No experience but posting for you to get a more helpful reply .
My goodness , you are going through it , it sounds horrendous , poor you .
I hope everything goes ok for you and you come out of the other side as soon as possible. Good luck .

Sorry to hear you’re having a tough time. I think you need to speak in detail with your hospital team about your home situation. Tell them you are unable to cope alone with the post op physical challenges and ask to be assessed for help and support. Say you will be unable to return home until help is in place such as daily carer visits for showering, meal prep etc and the district nurse to administer your iv antibiotics.

I hope you find the help you need. Best wishes for your recovery 💐

I agree you need to speak to your hospital team.

But I doubt you will be able to manage to home in the short term. Aside from your knee recovery, you also have other health challenges which will make being at home alone challenging, even with carers and district nurse popping in.

From what you have said, you have the money to book a respite place in a nursing home, and I would do that for a few weeks unless your hospital team advise otherwise. While you're there you can then assess at what point it is feasible to go back home with help.

One of my friends got an infection in her knee replacement (the details are hazy as this was about 7 years ago). They took the replacement out while waiting for the infection to heal, which as far as I recall took about two months, and during that time she was bedbound. She coped at home because her husband was there constantly. She then had another replacement put in and she recovered really quickly and has been absolutely fine.

I'm so sorry this has happened to you.

Thanks for this reply, it’s good to hear that she made a full recovery. I think things might have changed nowadays as I’ve been told that I will be helped out of bed while still in hospital to learn how to use a walking frame safely. They no longer advise bed rest as it’s a dvt risk.

I will definitely ask for a home assessment to get the support I need, I guess I just have to persevere and push. I need to know the plan first I think as if it’s a one stage procedure then I will be fine, I was on my own after just a couple of days live in support with my other knee replacement surgeries.

Now I’m fretting about how many times I’m going to need someone to come with me on hospital visits, it’s a large hospital and I won’t be able to walk through the corridors to the various departments. Based on my previous knee operations, I’ll need at least two more visits to consultant to get test results then to sign the consent papers, blood tests to see if infection has cleared, 2 pre op visits before each operation, staple removal and then a 6 week check up. I won’t be going there for physio as I prefer to use a local practice that I used before. So I reckon it’s at least 12 visits! I usually get a taxi to this hospital as parking is very limited even if I used my blue badge.

If I think too much about everything I will get very angry at what I’m going through, it’s not my fault, I did not cause this, I acquired the infection somewhere !

Huge sympathy op. I can empathise though my broken ankle is not as bad as your current issues. Getting around at the hospital is very difficult so I think you will need to ask for help from a friend or maybe ask if there is a porter to push you about in a wheelchair. When I went last week my daughter had to park in the multi story and go hunting for a wheelchair as I couldn't hop that distance with crutches or frame.

Well, I had the aspiration yesterday and although it was not too awful, it was not as pain free as the surgeon told me! However I did get some better news which has reduced my anxieties a little and I had the best night sleep I’ve has since I first got the bad news.

The blood results are back and show that my infection markers are 28, when less than 10 is normal and over 100 correlates to acute bacterial infections. According to Dr Google, 28 falls in the moderately elevated range, pointing to active inflammation and a mild to moderate bacterial infection. The fluid extracted today is off to the labs to find out what the bacteria is and if it is resistant to antibiotics..

My consultant seems to be veering towards doing just one operation to remove the existing implant ( only 5 months old), clean up the area then replace with a new implant. I will then have either IV or oral antibiotics and will be able to go home fully weight bearing after two or three days! Fingers crossed that this is the case!

I should know the final plan in a couple of weeks after he presents the case to the Muliti Disciplinary Team meeting a week tomorrow - I might even get a date for the surgery then.