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What kind of mobility can I expect with an antibiotic spacer in my hip

Posted by mrfish @mrfish, Nov 3, 2017

About 11 months ago, I had a total (right) hip replacement. No injuries led me to the decision to undergo that, just arthritic pain that had become gradually worse over 20+ years. Several months after the surgery, I developed an infection at the joint but it took a while to get that properly diagnosed. So, in less than two weeks I'll undergo the first of the two surgeries/stages to elminate the infection and replace the implant. I've read that the antibiotic spacer I'll have for 2-3 months will provide "limited mobility" but I'm struggling with what that really means. I'd apperciate any further information I can get from others who have undergone this same procedure. I expect 2-3 days of hospitalization following the surgery and IV antibiotic infusions several times a day (self-administered).

I'm an (otherwise) healthy 48yo male and I was very happy with how quickly I was able to bounce back from the original hip replacment. I'm sure there will be a week or so of recovery from the surgery itself -- but after that am I going to be mostly home-bound for the interim, or is driving myself and working in an office setting (on a limited schedule) a possibility? What other aspects are there to living for a with a hip spacer?

Thank you in advance for your help on this,
Art in Alaska.

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jdenn | @jdenn | Aug 18 7:59pm
In reply to @lahipster "If there are other options, I'd like to know them too. From reading this forum, it..." + (show)
@lahipster

If there are other options, I'd like to know them too. From reading this forum, it seems like everyone's experiences with spacers are different. One forum member even says he has returned to work with a spacer. I could have if work from home was still an option for me.
For the most part I can "walk" for about 10 steps or so with a walker, or at least until it's just too painful. The pain is manageable now without meds, but every time I move my affected leg it's a different type of discomfort.
I finally have an appointment with a orthopedist specializing in reconstruction, since my femur is fractured and damaged from the last prosthesis removal. If I'm eligible for a new implant, glorious! If not, it looks like I'll be hipless. It seems like this experience also varies by the individual. Stay tuned.

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Oh man I wish you the best. That is something I fear.

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LA Hipster | @lahipster | Aug 26 2:26pm
In reply to @jdenn "I have had 8 surgeries for my hip in the last 17 months. 1st was a..." + (show)
@jdenn

I have had 8 surgeries for my hip in the last 17 months. 1st was a hip revision followed by 2 interior pop outs. Excruciatingly painful. 2nd surgery was to redo what he had just put in. I forgot to mention I have a lot of bone loss at the top of the femur so some things were wired in. In May they did a debridement of the incision as it was not looking good. In July they found I had an infection, not Staph,in the wound and was put on IV antibiotics. Developed an allergic reaction to the antibiotics and had to go oral. In November I still had 2 holes in the incision but they were finally closing. After Thanksgiving my husband noticed a new hole had opened and back to Dr. MRI AND CAT SCAN showed a pocket of fluid had developed. In for surgery to clean everything. Sample of hip fluid showed no infection. 10 days after surgery my thigh and hip started having great pain. Went to ER and the holes broke open with disgusting fluid. I had STAPH. My Dr. Decided to go the heavy duty antibiotic route instead of taking everything out. For Christmas into the 2nd week of January I was very sick from the antibiotics. Finally got picc line removed but was on oral. Infection numbers came down. In June I started having pain in hip thigh again. Blood work showed that inflammation was 200. Went in for surgery and had everything removed and spacer put in. Was in pain always with the spacer. Last week went to Dr. To plan next step as was ending another picc line. Made plans to have hip replacement done in late. September. On the way home getting out car the spacer popped out. Back to ER and another surgery to redo spacer. No sign of infection and Dr will take me off antibiotics in 2 weeks. 2 weeks later do an aspiration. If all cultures come back negative he will do real replacement. After 3 pop outs I am now scared to death to do anything for fear of hip pop out. Sorry this is long but glad I found this forum.

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My surgeon took and abundance of caution - I was on antibiotics and the antibiotic-infused hip spacer nearly a year. No pop outs or rise in infection, but I was mostly unable to walk with a walker past 100 feet or so. After debridements and aspirations my infectious diseases doctor and orthopaedic surgeon decided that I would likely be on an antibiotic infusion every day for life. I'm taking Ertepenem, and there does not seem to be an oral version, so I have a PICC line I use daily for infusion.
There will be some long term effects of the antibiotics, but for now I'm glad to have my mobility and life back. The alternative to stopping the antibiotics is just hoping the infection doesn't get worse, since according to infectious diseases it can't be eradicated. If I stop and the infection flares up, I'm at risk for an amputation. I'm staying with the antibiotics. My surgeon informs me that I have 'no more surgeries left' for my hip and femur. Tough choices, but I'm hoping I can tolerate the antibiotic indefinitely. Good luck with your situation.

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kbmielke | @kbmielke | 21 hours ago

My husband is 65, had right THA, anterior approach, for end stage arthritis 4 months ago. He fractured the femur around the stem 1 month later so had a revision, posterior approach. The next month he got an infection and had washout followed by explant several days later with non articulating spacer placed, all posterior approach. He went to inpatient rehab for 2 weeks. He has completed 6 weeks of IV antibiotics and his PICC line was removed yesterday.
He has pain 1-2/10 managed with Tylenol or Advil. He uses a walker to move around our one-story home on 1 leg, or uses either a manual or electric wheelchair. We installed a walk-in tub which he enjoys greatly. I administered the antibiotics, help him in and out of bed, with bathing/dressing, and take care of all household chores. I also do all the driving. He returned to work remotely half-time at 3 weeks from the last procedure. He is only able to do administrative work as his primary work tasks involve standing and physical exertion. We are fortunate he has this option to keep busy.
Helpful things: foot loop and bed rail for getting in and out of bed, toilet riser and non-electric bidet, toilet grab bars, adjustable bed bases, urinal, wheelchair accessible van (purchased, as rental is crazy expensive), single step ramps for front and rear entrances, lift recliner, chair riser blocks for favorite easy chair, gel seat for wheelchair, Normatec 3 pneumatic pressure leg device (can use for just one leg, level 5 for 45 min does the trick for swelling after sitting too long), Vim&Vigr compression stockings (so fashionable 😍) and sock aid.
We are going to Mayo in 2 weeks for an opinion on the revision and will likely return to have the surgery done there.

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