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.

Interested in more discussions like this? Go to the Joint Replacements Support Group.

@mrfish

I made it to my 3-month anniversary last week (finishing antibiotics) and within just a couple of days I think it's back (and, of course, it shows up on a Friday evening so I can't get in to see my infectious disease doc until Monday). If I need to go through it all again, I think I need to consider something different. @lynzze, you and others have recommended getting into a Mayo facility, where did you go? I see there's a facility in Scottsdale, AZ (and it's in-network with my insurance). The idea of extended travel for this worries me, but there's that saying about the definition of insanity...

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Hi! I’m new to this Mayo Clinic connect. I was searching for living with an antibiotic spacer and mobility expectations when I came across your original post back in November 2017. I’ve been looking at this thread and I see you’re quite far in your journey. I’m so sorry the infection appears to be back. I just had surgery in May at the Mayo Clinic in Rochester Minnesota. I’m from Texas. I lived with my staff infection for about 4 1/2 years on suppressive therapy (Bactrim 1 pill a day) when I saw a sought a second opinion from the infectious disease and orthopedic surgeon at the Mayo. I traveled with my mom and we took our two small dogs with us. We knew we would be there for at least the six weeks of IV antibiotic treatment after I got my spacer put in. I rented a small house through Home Away that worked out well. I did some research through the male clinic and they had housing recommendations but those I found didn’t take dogs or I would have used one of them. Of course I had time to do a lot of planning because it took me a long while to really commit and make the decision once they gave me their opinion. It differed from my doctors here in Texas and I was confused. I have a very good surgeon here in Texas as well as my infectious disease doctor but I was 42 at the time and they were worried about me losing my hip entirely because I’ve had so many surgeries on it in the past and I don’t have a whole lot of bone left. I’m happy to say that the infectious disease doctors and the surgeon at the Mayo are amazing. My level of care there was outstanding and I am hopeful this infection is gone. I am trying to make it a full year with my spacer to make sure before I try to do it all over again. I definitely feel that finding the right surgeon is the best. I’m not sure what type of infection you have or your timeframe on things but if I can help answer any questions on traveling for surgery I’m happy to help anyway I can. I was looking at the various Mayo Clinic locations and I went to Rochester because I had read an article of what they were working on for a non-surgical cure implant related infections and that was being done in Rochester. I had hoped that they were closer and perhaps I could wait a bit longer but it appears there a long way off. From what I am told of others who have been at the Mayo Clinic Rochester was an excellent choice for orthopedics and infectious disease.

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@crgentry

Hi! I’m new to this Mayo Clinic connect. I was searching for living with an antibiotic spacer and mobility expectations when I came across your original post back in November 2017. I’ve been looking at this thread and I see you’re quite far in your journey. I’m so sorry the infection appears to be back. I just had surgery in May at the Mayo Clinic in Rochester Minnesota. I’m from Texas. I lived with my staff infection for about 4 1/2 years on suppressive therapy (Bactrim 1 pill a day) when I saw a sought a second opinion from the infectious disease and orthopedic surgeon at the Mayo. I traveled with my mom and we took our two small dogs with us. We knew we would be there for at least the six weeks of IV antibiotic treatment after I got my spacer put in. I rented a small house through Home Away that worked out well. I did some research through the male clinic and they had housing recommendations but those I found didn’t take dogs or I would have used one of them. Of course I had time to do a lot of planning because it took me a long while to really commit and make the decision once they gave me their opinion. It differed from my doctors here in Texas and I was confused. I have a very good surgeon here in Texas as well as my infectious disease doctor but I was 42 at the time and they were worried about me losing my hip entirely because I’ve had so many surgeries on it in the past and I don’t have a whole lot of bone left. I’m happy to say that the infectious disease doctors and the surgeon at the Mayo are amazing. My level of care there was outstanding and I am hopeful this infection is gone. I am trying to make it a full year with my spacer to make sure before I try to do it all over again. I definitely feel that finding the right surgeon is the best. I’m not sure what type of infection you have or your timeframe on things but if I can help answer any questions on traveling for surgery I’m happy to help anyway I can. I was looking at the various Mayo Clinic locations and I went to Rochester because I had read an article of what they were working on for a non-surgical cure implant related infections and that was being done in Rochester. I had hoped that they were closer and perhaps I could wait a bit longer but it appears there a long way off. From what I am told of others who have been at the Mayo Clinic Rochester was an excellent choice for orthopedics and infectious disease.

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Sorry for the grammar errors. That’s me talking into my phone 🙂

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Sorry to hear of your health problems. I have had 5 knee surgeries on my left knee and (4 new knee joints ) one was an Antibiotic Spacer. I was told not to put any weight on the spacer which prevented me doing any exercise or walking. I used a Walker to lift myself off the floor as I moved my right leg into position. I have knee joint #4 in place now praying for a more successful outcome. But we'll see.

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@crgentry

Hi! I’m new to this Mayo Clinic connect. I was searching for living with an antibiotic spacer and mobility expectations when I came across your original post back in November 2017. I’ve been looking at this thread and I see you’re quite far in your journey. I’m so sorry the infection appears to be back. I just had surgery in May at the Mayo Clinic in Rochester Minnesota. I’m from Texas. I lived with my staff infection for about 4 1/2 years on suppressive therapy (Bactrim 1 pill a day) when I saw a sought a second opinion from the infectious disease and orthopedic surgeon at the Mayo. I traveled with my mom and we took our two small dogs with us. We knew we would be there for at least the six weeks of IV antibiotic treatment after I got my spacer put in. I rented a small house through Home Away that worked out well. I did some research through the male clinic and they had housing recommendations but those I found didn’t take dogs or I would have used one of them. Of course I had time to do a lot of planning because it took me a long while to really commit and make the decision once they gave me their opinion. It differed from my doctors here in Texas and I was confused. I have a very good surgeon here in Texas as well as my infectious disease doctor but I was 42 at the time and they were worried about me losing my hip entirely because I’ve had so many surgeries on it in the past and I don’t have a whole lot of bone left. I’m happy to say that the infectious disease doctors and the surgeon at the Mayo are amazing. My level of care there was outstanding and I am hopeful this infection is gone. I am trying to make it a full year with my spacer to make sure before I try to do it all over again. I definitely feel that finding the right surgeon is the best. I’m not sure what type of infection you have or your timeframe on things but if I can help answer any questions on traveling for surgery I’m happy to help anyway I can. I was looking at the various Mayo Clinic locations and I went to Rochester because I had read an article of what they were working on for a non-surgical cure implant related infections and that was being done in Rochester. I had hoped that they were closer and perhaps I could wait a bit longer but it appears there a long way off. From what I am told of others who have been at the Mayo Clinic Rochester was an excellent choice for orthopedics and infectious disease.

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Thank you Candace. Wow...a year w/ a spacer! I had mine for three months and was sooo glad to get it out...but my infection came back pretty quickly. Others on here who had experience with spacers recommened keeping it for as long as I could, so that's good advice. You've had the spacer for 4-5 months or so now...how well are you able to get around?

Fortunately my latest episode a few weeks ago turned out to be a false alarm (of sorts). I definitely had some kind of infection going on...swelling, redness and hot to the touch. It was on one side of my surical scar, but it was improving by the time I got in to see my infectious disease Doc. He thinks it might have been something superficial, and not originiating from the joint. He said "scars can do weird things sometimes". It scared the heck out of us, but he other times the joint infection presented, it also came with a loss of strength and flexibility. That didn't happen this time and I take a little comfort in that fact.

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@lturn9

Sorry to hear of your health problems. I have had 5 knee surgeries on my left knee and (4 new knee joints ) one was an Antibiotic Spacer. I was told not to put any weight on the spacer which prevented me doing any exercise or walking. I used a Walker to lift myself off the floor as I moved my right leg into position. I have knee joint #4 in place now praying for a more successful outcome. But we'll see.

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Praying #4 works well for you.

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@crgentry

Praying #4 works well for you.

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Thank you for your prayers! I hope others will remember me in their prayers as well.

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@mrfish

Thank you Candace. Wow...a year w/ a spacer! I had mine for three months and was sooo glad to get it out...but my infection came back pretty quickly. Others on here who had experience with spacers recommened keeping it for as long as I could, so that's good advice. You've had the spacer for 4-5 months or so now...how well are you able to get around?

Fortunately my latest episode a few weeks ago turned out to be a false alarm (of sorts). I definitely had some kind of infection going on...swelling, redness and hot to the touch. It was on one side of my surical scar, but it was improving by the time I got in to see my infectious disease Doc. He thinks it might have been something superficial, and not originiating from the joint. He said "scars can do weird things sometimes". It scared the heck out of us, but he other times the joint infection presented, it also came with a loss of strength and flexibility. That didn't happen this time and I take a little comfort in that fact.

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Oh my! I'm so glad to hear that. What a scare it was I'm sure. I pay your new hip continues to do well for you and no infection or any other complications.

I think I'm doing reasonably well with the spacer. I was toe touch weight bearing with my walker/crutches for about 5 weeks. The surgeon saw me before I left to head back home and I was released to drive home, weight bearing as tolerated, side leg lifts (a thousand a day he said jokingly), swimming, and very light stationary bicycle. It took me another couple weeks to put more weight on it. He wanted me to wean to just one crutch by the end of July and I made it. I do my side leg lifts, stretch regularly (whole body but carefully with the leg) and I've done some swimming, I feel the best in the water. It's sore in the front thigh area but I'll take sore any day over how crappy I was feeling with the infection. Every now and then I get some sharp pains when I do certain movements but not often and I can't identify what I'm doing so I just deal with it. I'm guessing it's the spacer, doesn't last long and it's tolerable. I think I was almost to make it to a cane the end of August but I tripped over a floor mat leaving a restaurant and had quite the setback. I did the try to keep yourself from falling thing and it was definitely not ready to take that weight or pressure in the front. I think I strained my thigh mussels and just tweaked my knee and whole leg in general. Back on two crutches I went. My massage lady has helped tremendously and is experienced in medical massage and orthopedics. Most importantly does not cost a fortune as most medical massage therapists do. I saw my Ortho here a little earlier than planned to make sure I did't hurt the spacer but it looks good and I'm about to send off my CD to the surgeon at Mayo and ask a few questions. I'm just now starting back to where I was before the trip thankfully.

Without some PT and more strength training I don't see me getting off my one crutch until I get my new hip. Which is fine, this leg has been through a lot of surgeries so I'm happy to wait it out to make sure and give myself the best chance for success with the final hip. I've got 40 pounds to loose so that will give me some time to get more healthy now that I feel good again.

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@crgentry

Oh my! I'm so glad to hear that. What a scare it was I'm sure. I pay your new hip continues to do well for you and no infection or any other complications.

I think I'm doing reasonably well with the spacer. I was toe touch weight bearing with my walker/crutches for about 5 weeks. The surgeon saw me before I left to head back home and I was released to drive home, weight bearing as tolerated, side leg lifts (a thousand a day he said jokingly), swimming, and very light stationary bicycle. It took me another couple weeks to put more weight on it. He wanted me to wean to just one crutch by the end of July and I made it. I do my side leg lifts, stretch regularly (whole body but carefully with the leg) and I've done some swimming, I feel the best in the water. It's sore in the front thigh area but I'll take sore any day over how crappy I was feeling with the infection. Every now and then I get some sharp pains when I do certain movements but not often and I can't identify what I'm doing so I just deal with it. I'm guessing it's the spacer, doesn't last long and it's tolerable. I think I was almost to make it to a cane the end of August but I tripped over a floor mat leaving a restaurant and had quite the setback. I did the try to keep yourself from falling thing and it was definitely not ready to take that weight or pressure in the front. I think I strained my thigh mussels and just tweaked my knee and whole leg in general. Back on two crutches I went. My massage lady has helped tremendously and is experienced in medical massage and orthopedics. Most importantly does not cost a fortune as most medical massage therapists do. I saw my Ortho here a little earlier than planned to make sure I did't hurt the spacer but it looks good and I'm about to send off my CD to the surgeon at Mayo and ask a few questions. I'm just now starting back to where I was before the trip thankfully.

Without some PT and more strength training I don't see me getting off my one crutch until I get my new hip. Which is fine, this leg has been through a lot of surgeries so I'm happy to wait it out to make sure and give myself the best chance for success with the final hip. I've got 40 pounds to loose so that will give me some time to get more healthy now that I feel good again.

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Hello from the UK. I've just spent the afternoon reading this thread. I wish I had found it earlier. I too have had a staph infection in a hip that was less than a year old. The bug I had was staphylococcus Caprae. I had a debridement in November 2017 and 6 weeks of oral antibiotics. The infection returned New Years eve! I had my hip removed 5/6/18 and a spacer inserted. I was in hospital 2 1/2 weeks had Vancomycin and oral Rifampicin. I came home on once day IV Teicoplanin and the Rifampacin. In total 7 weeks of antibiotics. Tomorrow I get the second stage hip replacement. It has been encouraging, Mr Fish to hear of your relief after the THR as although I have pain I havn't needed strong painkillers just Paracetamol and Diclofenac. I've had the occasional Tramadol about 2 per month. The grinding and popping makes me feel nauseous! I shall be glad to be free of that. I walk with a frame or crutches and am aloud 50% weight bearing. I know nobody that has had this surgery so would be lovely to chat to you all. Lin

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I had total hip replacement July 2016. It started bothering me in April 2018. A knot came up & went down twice in April & May. The 2nd time it was golf ball sized & you could see it through my jeans. It busted & drained everyday for 13 days. I went to urgent care during that time & they did a culture, which came back & they tried 3 different antibiotics. I had my year check up with ortho & they did an aspiration & found pseudomonas infection. I had the hardware removed & an antibiotic spacer put in August 1st. I did 6 wks of IV antibiotics (3 times/day). They took my pics line out & I went 2 & 1/2 wks with no antibiotics. Another aspiration was done. I got the results Wednesday & nothing grew in the culture. But, my ortho dr is not able to schedule surgery until the week before Christmas!! And the Dr I saw (my regular ortho dr was in surgery) said they may or may not put a new hip in on that date. If it looks good they will, but if they don't like what they see, they'll take this spacer out & put another in. And there's a chance (a pretty good 1 according to him), that I'll be on oral antibiotics the rest of my life!! I'm only 42 yrs old & I kinda plan on living quite a while longer. I've been walking with no crutches or anything for 2 wks, even went to Dr appt without crutches. They said it was probably OK since I only weigh about 115lbs. Is it REALLY ok to go for prolonged periods walking with no help??

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@linjane

Hello from the UK. I've just spent the afternoon reading this thread. I wish I had found it earlier. I too have had a staph infection in a hip that was less than a year old. The bug I had was staphylococcus Caprae. I had a debridement in November 2017 and 6 weeks of oral antibiotics. The infection returned New Years eve! I had my hip removed 5/6/18 and a spacer inserted. I was in hospital 2 1/2 weeks had Vancomycin and oral Rifampicin. I came home on once day IV Teicoplanin and the Rifampacin. In total 7 weeks of antibiotics. Tomorrow I get the second stage hip replacement. It has been encouraging, Mr Fish to hear of your relief after the THR as although I have pain I havn't needed strong painkillers just Paracetamol and Diclofenac. I've had the occasional Tramadol about 2 per month. The grinding and popping makes me feel nauseous! I shall be glad to be free of that. I walk with a frame or crutches and am aloud 50% weight bearing. I know nobody that has had this surgery so would be lovely to chat to you all. Lin

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Hello @linjane and @juskunfuzed. Welcome to Mayo Clinic Connect!

Jane, best of luck with your surgery tomorrow- please stop back and keep us updated on your progress.
@juskunfuzed- call every day to see if an earlier surgery has opened up. People cancel appointments all the time. Also, please call and talk with your primary about using your crutches and walking with no help. I agree with you- 42 is young to be taking a daily antibiotic for the rest of your life. Get another opinion and let me know what you decide. I'm interested to see what your doctor says.

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