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47 years old having TKA revision with static spacer block then new TKA
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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can you share your story ? why so many revisions ?
Not all for the same reasons but all have resulted in the same outcome, contracture with aggressive scar tissue, flexion and extension issues. Each time was an attempt to stablize, change design of the implant or because it became loose. Soft tissues are pretty messed up, after one surgery I ended up with a focal Dystonia that required quarterly Botox in quads and hams that took 18 months to resolve. Now after 7 years of this and my good leg doing all of the work, my good leg is showing signs of arthritis and there are times I can barely walk for the pain and stiffness. I’m pretty discouraged
wish you well ! i hope i am done and on the mend !
The cast will be from mid-thigh down to my toes, and the bottom of the cast under my heel will be built up, so technically I will be able to put a little weight on it. Some people prefer to use walkers instead of crutches, so I will be ambulatory somewhat to get around my house but no heavy lifting and no heavy activity. The reason for the cast is so that the cement spacer block won't be dislodged with movement and the antibiotic will be released where it needs to be.
I'll keep you posted after my surgery on Thursday!
Oh man, I completely understand your frustrations, I am active and do a lot of ballet and yoga and mobility and light weightlifting, and I'm stuck with this for a while.
Keep doing all of those activities! I hope to be back to them in a year or so, to me, the pain is awful but worth it.
(but it really hurts!)
Ugh, i know that pain!!!!
Very best of luck to you! You have a great attitude
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1 ReactionThank you, the truth is I’ve cried every day and I’m leaning heavily on my family and friends promotional support. Being young and active and going through the last three years with a new replacement, needing another one on my other knee, and after having four total surgeries on my left knee, I feel like if I don’t constantly remind myself that everything will be OK, then I’m not really even sure how I would get through it. I know this is a one day at a time kind of thing, but sometimes it’s five minutes at a time, and I’m just trying to get back to being healthy and pain-free with good knees.
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1 ReactionThat seems normal. I think anyone that went through what you’re going through would feel the same way. For sure and probably many of your friends can’t even relate to what you’re going through. It’s a lonely path and I hope all the best for you. Don’t ever feel bad for feeling down or even sorry for yourself because that seems completely absolutely normal!
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2 ReactionsHi,
Had my TKA this past January at 52. I’ve always been healthy and active. Within a month or two, the knee started swelling and remained so despite numerous drainings. The fluid was always bloody red. In just one draining, 130 ml was removed.
In July the fluid tested positive for Staphylococcus Salivarius and I was placed on an oral steroid for 10 days.
In August I tested negative for any infection including metal allergies but the swelling remained. The original surgeon reopened the knee, removed synovium and installed a plastic button behind the degraded knee cap. A week later it was just as swollen as before. He drained it and it was the same bloody fluid but it tested negative for infection.
This surgeon’s approach had always been “come back in 4-5 weeks and continue PT”. PT had been useless and my muscles had atrophied horribly because my knee was so swollen. The knee had also become very unstable.
One week ago I went to a new surgeon who immediately recognized there was an issue. Numerous tests were conducted and all were negative for infection but he was convinced it’s in there based on the long term swelling. He got me into surgery yesterday and removed the original implant and installed an antibiotic spacer. He said there was evidence of necrosis in the tissue. So far all tests he conducted for infection have been negative. I now have a pic line for antibiotics which I’ll be taught how to administer today. Hopefully the line will come out in 6 weeks. A new implant will be installed around 3 months.
The antibiotic joint is very noisy. My wife can hear it clearly when I move. It’s disturbing mentally and physically. I have a call into the surgeon to ask about that.
I feel your frustration and pain. I haven’t been able to my preferred activities (mountain biking, hiking and motorcycling) since last Fall and won’t be for the foreseeable future. I’m hopeful this new surgeon and his 30 years of experience are the answers to my problems.
Good luck and keep looking forward.
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