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

Hi @mrfish I have followed your journey and ups and downs with interest. I am in a similar position and would gratefully accept anyone's advice. I am 70 years old and retired having lived a healthy life until .....

I had my left hip replacement in December 2014 following a fall after finishing radiotherapy for a breast cancer operation in October 2013. All went well with the recuperation of the hip replacement following 6 weeks of no weight bearing using a walker for 6 weeks and 18 PT sessions (quite useless actually).

In October 2017 I had another fall and after two hospital visits, X-Rays, MRI and PT for knee problems, during which time I could not walk, a visit to a private Ortho Specialist in February suggested it was more hip than knee problems and took an X-Ray which showed the stem was loose and had slipped. Briefly, back to original Surgeon, a car accident on the way to pre--ops and 3 hospitals later I came home with a knee replacement, hop revision to be done 6 months later after bone strengthening due to diagnosis of Osteoporosis. Six months pass and October 18 hip revision scheduled. Opened up and infection discovered, hip and femur power washed, spacer installed and put in isolation on IV antibiotics. Five days later infection identified as E-Col, put o appropriate antibiotics (Amoxcillin/Clavulanic Acid) via IV and taken out of isolation. After 8 days taken off IV due to veins collapsing, put on tablets 3xday and sent home with 'no weight bearing' instructions. I have to have blood tests every two weeks and this week was told things going well and cut back medication to 2xday due to my weight (115lns), I have to have 4 weeks clear before replacement can be scheduled.

I am finding it difficult to manage life in general. My staples were removed last Friday and I have a well healed scar. My problem is I cannot manage hopping or standing on one foot. My husband is a Godsend but I know it is a strain on him mentally and physically as I did everything (shopping/cooking/cleaning/gardening) for 50 years besides working full time.

Sorry this is so long but I just need support and encouragement to get me through this difficult time.

.... Disabled in Portugal ....

Hi @lioness You have to laugh or you'd cry! Why do these bugs creep up/into us? Actually, my Surgeon and Internist both told me that we all have E--Coli in our system but only 1% will get it, especially if you have something foreign in your body, ie, replacements! The silent killers, like Cancer ... I was perfectly healthy when mine was diagnosed!

I will do my utmost to avoid such aliens in the future!

Have a nice weekend. Hope you are safe from the fires.

@izabel Thanks yes Im not in the fire areas I know what you mean I have the herpes and Epstein-Barr in me since I had chicken pox and mono. We just have to try and navigate the mine fields.Have a nice Thanksgiving.

@jimandlisa Thank you for responding (Lisa, I assume). Does your husband manage well on one foot with a walker? I find it difficult with personal everyday tasks and get weepy whereas I am normally a strong-willed person. I will follow your progress and wish you wellness for the new year.

@linjane Pleased you are doing well. This is really a fight with these viruses. When I was admitted to the hospital for my knee replacement I had contracted MRSA from the previous hospital so on IV antibiotics and into isolation I went before surgery. Needless to say they double checked me for MRSA this time but instead I brought E-Coli to the table!!!

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.

I'm catching up on reading all the postings in this discussion. I hope you are still free of infection since your false alarm episode that occurred approximately 3 months after your last IV antibiotics treatment. Today is the first day of my 3-month observation period in which I need to be free of infection for the doctors to say I am clear of an MRSA infection of the tissue near the incision (that hopefully never attached to my prosthesis) following my September THR. Yesterday I finished my 6 weeks of daily antibiotic infusions, which began with my October debridement surgery.
If my infection returns, then I will have to travel a path similar to yours, but my surgeon mentioned 2-stage rather than 1-stage for a 2nd THR. Apparently your surgeon gave you the option for 1-stage. Can I ask you to comment on that again?
Also, did the subject of a "salvage" procedure (resection arthroplasty, or "Girdlestone") ever come up as the most successful way to eradicate infection, albeit with functional outcomes that do not compare well with a successful THR?
Thank you for your time.

Hi Jbro. My debridement was Nov 2017 with 6 weeks of oral antibiotics. However within 2 weeks of stopping I was very flulike with all the red flags for prosthesis infection. The only option for me in the UK was 2 stage hip replacement with the antibiotic spacer. I had this in June ( things move slowly with the nhs) I beleave this is gold standard treatment. Don't think I would have been happy with girdlestone surely that's last resort. Seen my consultant today all is going well and can start weight bearing in 2 weeks. We have also been given the go ahead to book a holiday, very much needed. I hope your debridement is successful and you don't have to go down this path. If you do it's just a case of putting your life on hold and getting through it. Good luck.
Lin

When you had flulike symptoms 2 weeks after stopping your 6 week antibiotics, did they immediately aspirate the hip joint to confirm the infection, and type? Then, did you have surgery right away to remove the prosthesis and have it replaced with a temporary cement spacer, which was subsequently replaced with a new prosthesis in June? If yes, how challenging was the recovery with the spacer?
Thank you for your time. I’m trying to get my mind around what may be ahead.

Hi Jbro . Unfortunately in answer to your question the answer was no! I had to wait 9 weeks to get the MRI and result then the aspiration was done the next day! I then had to go 12 weeks to get his funding for the operation. The NHS is in crisis over here. I tried to go privatley to speed the process but the services were too fragmented. My consultant wanted all my care under the same roof. Even he was very frustrated at the time it took. The prosthesis came out in June this is when the spacer was fitted. It was a tough 4 months but I think reading all the above threads I had it easier than most as I could 50% weight bear and a good physio. It was only replaced at end of October. I'm still ploughing through the antibiotics. I feel confident it will be ok as it feels very good, the other hip never did. Good luck I hope you don't need the surgery. It sounds like they got on top of your infection very quickly. So hopefully you will be ok.
Lin

Hi Jbro. My debridement was Nov 2017 with 6 weeks of oral antibiotics. However within 2 weeks of stopping I was very flulike with all the red flags for prosthesis infection. The only option for me in the UK was 2 stage hip replacement with the antibiotic spacer. I had this in June ( things move slowly with the nhs) I beleave this is gold standard treatment. Don't think I would have been happy with girdlestone surely that's last resort. Seen my consultant today all is going well and can start weight bearing in 2 weeks. We have also been given the go ahead to book a holiday, very much needed. I hope your debridement is successful and you don't have to go down this path. If you do it's just a case of putting your life on hold and getting through it. Good luck.
Lin