47 years old having TKA revision with static spacer block then new TKA

Posted by youngtkawarrior @youngtkawarrior, Sep 12 4:34pm

Hi all, I am 47 years old and had my first TKA in May of 2022. I am athletic, not immunosuppressed and otherwise healthy. This June (2024)- two years after my very successful first TKA I had a staph aureous infection in my knee and my dr performed a washout procedure, in which he reopened my incision, cleaned the infection, replaced a small part of the implant, and I was on 6 weeks of IV antibiotics via a PICC line which I administered myself. After the 6 weeks, I transitioned to oral antibiotics for the rest of my life.

I recovered very quickly, and by Labor Day I was back carefully going to ballet and yoga. However, my knee started to swell, I went to my DR yesterday and I now still have a staph aureus infection and they are going to open up my knee, remove the metal in the implant an replace it with a cement static spacer block (which is infused with antibiotics).

I will be "immobile" with a cast on my leg from my hip to my toes for 3 months and THEN will have a second surgery to remove the spacer, the old imp,ant and put in a new implant. So basically I'm starting over from the original implant from May 2022 only with 3 months of atrophied muscles and tight connective tissues (ligaments, etc) from being immobile in the cast.

My questions are numerous- has anyone had this done? what is the recovery time- I know a year, but what really happens? how do you manage with the whole leg cast? Has anyone had this procedure and had to do it more than once?

I started this journey when I was 45, and I know I'm a young candidate, and the rate of infection is 1-2%, and now I have a reinfection, so what is the rate of success after this? my head is really spinning and I don't know anyone who has gone through this at my age...

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I’m so sorry I don’t know your age, but I don’t believe that one or 2%. I got an infection also And have had to go through the washout and all the antibiotics. What I would like to tell you is all the atrophy in my Body made me carry more strength on my upper body, and I tore out both my rotator cuff. I only recently found out that some of the antibiotics they had me on IV with a picc line. Are known to make the tenants very brittle and prone to snapping and damage. I think they have some medication and supplements that will help the tendons as well as I’m definitely hearing that PRP helps tendon healing, but from here on in I would be really careful about the rest of your body. You’ll have to depend on it and you don’t want to do further damage. That’s the boat I’m in. I’m a very useful 67 use to swimming at least a mile 3 to 4 times a week and being an active Gardening and such. I just wish I would’ve known about the tendon situation , at least a few have the rest of your body and reasonable health. It will be easier for you to go through it. I expect the same thing will happen to me down the line with my hip, but there’s nothing I can do about it now. best of luck to you , you sound like a lovely person and I hope fabulous healing!

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If you notice going to parties and events and talking to people, there are so many people that have had hip and knee infections that it’s no way it’s one or 2%. I run into that one or 2% is all the time!

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I had the knee infection Dec/15/23 , the first operation they just opened me up and did a clean out of the joint, was on an antibiotic pump for 2 months , 2 days after i was finished the antibiotics i was still infected so then they removed the metal from a 2018 knee replacement and put in the antibiotic infused cement spacer, i did not have a cast but was able to hobble around for 3months until they performed the TKR May/28/24, with all the bone loss from 2nd surgery doc installed longer stems than normal ,nearly 4 months out i am dealing with stem pain in my shin and right hand calf area, at times this is very painful like a very severe case of shin splints some days okay some days are terrible pain still ! Doc says body has to adjust to the stem driven into the bone , it can take a long time to adjust , maybe year or more

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I would like to communicate more with you and the others who have posted this similar situation as to helps and hints to better healing along the way !

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@vickyvanvliet

I’m so sorry I don’t know your age, but I don’t believe that one or 2%. I got an infection also And have had to go through the washout and all the antibiotics. What I would like to tell you is all the atrophy in my Body made me carry more strength on my upper body, and I tore out both my rotator cuff. I only recently found out that some of the antibiotics they had me on IV with a picc line. Are known to make the tenants very brittle and prone to snapping and damage. I think they have some medication and supplements that will help the tendons as well as I’m definitely hearing that PRP helps tendon healing, but from here on in I would be really careful about the rest of your body. You’ll have to depend on it and you don’t want to do further damage. That’s the boat I’m in. I’m a very useful 67 use to swimming at least a mile 3 to 4 times a week and being an active Gardening and such. I just wish I would’ve known about the tendon situation , at least a few have the rest of your body and reasonable health. It will be easier for you to go through it. I expect the same thing will happen to me down the line with my hip, but there’s nothing I can do about it now. best of luck to you , you sound like a lovely person and I hope fabulous healing!

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Hi, Thanks for your share- the 1-2% statistic of for total knee replacements that become infected. So out of 100 people who have had TKAs, 1-2 people will get an infection.

I do see a lot of people who have the same knee replacement scars out in public, but that doesn't mean they have had an infection, just the replacement. I would recommend yoga and ballet barre classes and lots of biking if you like being active 🙂 all of this will keep your core strength and barre classes use light weights which would be perfect for your rotator mobility and strength. Good luck!

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@fcarlsen12

I would like to communicate more with you and the others who have posted this similar situation as to helps and hints to better healing along the way !

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Absolutely! I will post my progress here and invite any and all questions. I do know that my antibiotic-infused cement block spacer is a static spacer so I will not be able to move at all during the 3 months that I have it in- I'll have a cast that they change every 6 weeks. (whoo hoo.)

I asked my orthosurgeon about the static spacer vs movable one, and he said he found more people had pain and also dislocated the spacer when they had the ability to move it, which is why he chose the immobility option.

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will you be able to walk with it?

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@youngtkawarrior

Hi, Thanks for your share- the 1-2% statistic of for total knee replacements that become infected. So out of 100 people who have had TKAs, 1-2 people will get an infection.

I do see a lot of people who have the same knee replacement scars out in public, but that doesn't mean they have had an infection, just the replacement. I would recommend yoga and ballet barre classes and lots of biking if you like being active 🙂 all of this will keep your core strength and barre classes use light weights which would be perfect for your rotator mobility and strength. Good luck!

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i was very active before the bug hit me , now i am trying to do was i was doing pre-op but it is tough , first of all i cannot walk a block without pain coming on , i love biking , i ride my bike on a wind trainer for 15-20 minutes and i really pay for that for the next 3 days , therefore not ready for the bike yet , i did swim a long time ago and i have started again about 3 weeks ago , i have worked myself up to 1/2 mile swims now and things feel great ! i golfed 3-4 times a week , Sept/14 our club had their annual mixed scramble windup tourney, i was talked into giving it a go , not good for knee and shin but i survived , i am a snowbird so looks this AZ winter will be a rehab one !

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@fcarlsen12

I had the knee infection Dec/15/23 , the first operation they just opened me up and did a clean out of the joint, was on an antibiotic pump for 2 months , 2 days after i was finished the antibiotics i was still infected so then they removed the metal from a 2018 knee replacement and put in the antibiotic infused cement spacer, i did not have a cast but was able to hobble around for 3months until they performed the TKR May/28/24, with all the bone loss from 2nd surgery doc installed longer stems than normal ,nearly 4 months out i am dealing with stem pain in my shin and right hand calf area, at times this is very painful like a very severe case of shin splints some days okay some days are terrible pain still ! Doc says body has to adjust to the stem driven into the bone , it can take a long time to adjust , maybe year or more

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I have long posts now after multiple revisions and it took probably 6-9 months before the tibia pain got better. Similar, felt like a bad shin splint but after micro movements the bone actually strengthens

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thank you ! the most positive comment i have heard yet ! hopefully things improve in the new year !

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