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What kind of mobility can I expect with an antibiotic spacer in my hip
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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@jbro. I had the MRSA on March when I had the TKR ... well, to be specific the week before as I had contracted it at the previous hospital I transferred from. I was in isolation for 5 days and I don't know what antibiotic I was on but it cleared in that my Surgeon performed the TKR. This current E-Coli infection is in my hip discovered when Surgeon (same one as knee) opened me to do Hip Revision, originally having been done in December 2014 at the hospital where I contracted the MRSA! The current hospital (private) tested me twice during the last episode for MRSA with negative results.
I understand even those in the medical profession do not know how or why some get infections. My Infectious Diseases doctor told me we all have E-Coli in our system (like Herpes) and sometimes it just comes out to play! He said perhaps it saw a foreign body (ie my hip prothesis) and decided to go reside there! Better there than the liver and kidneys which has devastating consequences. Both of my are currently checked regularly.
I know people don't agree using the same Surgeon for knees and hips let alone revisions ... but this guy is tops and been with this hospital 18 years and well respected and recommended. My TKR in March has great ROM and is straight and the scar is fading into oblivion. He also takes time with me and he has a wonderful bedside manner. He visited every day in hospital (16 days) even donning hazmat gear, I have never seen a PA and even he calls me at home with results. Could not ask for better.
I am wishing everyone on here to have a good healthy 2019.
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1 ReactionLin, I DO NOT walk on my spacer for fear of falling especially with the LLD of 5cms ... but we WILL all get there in time. Beijinhos xx
@izabel I can't believe all you have been through. It's frightening to think that those things can happen, but thankfully yours was apparently dealt with well.
Your surgeon sounds great. If I needed a revision I too would go to the same surgeon whom I had for my last TKR. I would not have gone to the same surgeon who did my first TKR. Most knee surgeons around here do not do hips though, and vice versa. Things are so specialized in orthopedics -- hand doctors, spine, knee, hip, shoulder. I guess it may be good because then that doctor is definitely well versed in that area, but your doctor really does sound special.
Looking forward to hearing what your surgeon has to say on the 15th, hopefully all good.
JK
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1 Reaction@lynzze, Hi my name is Neka and I'm currently dealing with an antibiotic spacers and it has been very painful the whole time. Today is my last day of antibiotic treatment I'm just nervous because the doctors were never able to figure out what type of staph infection I was dealing with. Since you've dealt with it what would you suggest about me going forward with getting the hip replacement surgery done after antibiotic treatment
Hi Neka. Nice talking to you. I should have waited wait 6 weeks and had low CRP and ESR before they proceeded. This indicated that the infection in the tissues surrounding the device were free from infection. I had to wait longer as I couldn't get an operating slot. The surgeon then took swabs at the surgery all of which were still positive for Staph Caprae. (You cannot eradicate the infection on the biofilm of the device once it's there. This will continue to reinfect if not treated). Once the device was out I was given Vancomycin twice a day until the swabs taken during the op came back negative. They didn't! They came back showing another potential staph infection. My microbiologist felt it was a contaminent as it didn't show for 10 days. So I had to have another 6 weeks of oral antibiotics. I feel well for the first time since the initial hip replacement went in and this is what reassures me. The infection had made me very anaemic and had affected my liver and kidneys. The recent blood tests show this is now correcting. There really is nothing you can do but have trust in your surgeon I have to say mine is a brilliant man. I just class myself as unfortunate this has happened to me. I really wish you well please let me know how you are. Lin x
@linjane I was taking three different antibiotics at first vancomycin, rosephin, and ranvampyn. I hope I spelled them correctly...lol, but I started having a reaction to vancomycin and the rosephin, and the ranvampyn (which was an oral antibiotic). So they took me off the vancomycin and rosephin. And replaced it with ranvampyn in iv form, and teflero. I'm just hoping they cleared the infection, because this spacer is very uncomfortable and painful. I've had the spacer in now since November 7
I can sympathize completly looking back and its still early days for me so mobility is not all as I would like it but I'm getting there. The spacer is an evil instrument of torture! Can you weight bare at all? I just realised I was also on oral Rifampacin with the Vancomycin! When I left hospital they stopped the Vancomycin and switched it to Teicoplannin which is once a day.The drugs you talk about are very powerful and broad spectrum. it's just a shame you don't know what infection you are fighting as you could have definitive confidence that they are the right ones. This is a waiting game for us all and every stage is full of angst. You must have confidence and positivity and if your inflammatory markers are decreasing take hope from that. I'm sending all the positivity I can. Please let me know how you get on. Lin x
I am really stunned hearing about people getting staph infections from a joint replacement. I think if I had known this before my two knee replacements I may not have had them and just lived in pain. Does anyone know the percentage of people who end up having to go through this?
JK
Hi JK. The figure I was given was less than 1% for hips. Many of the staff on the orthopaedic ward I was on had never nursed anyone that had had my procedure. I have no idea for knee but I seem to that this may be higher but don't quite me. You are one of the lucky ones. Lin
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1 Reaction@linjane Thanks, Lin. I guess you are right, I am one of the lucky ones. This is absolutely frightening. My brother-in-law just had a hip replacement and he is doing great also. I do know many people who have had either hip or knee replacements and none of them have gone through this, so I suppose it must be a small percentage, but it sounds like an absolutely terrible thing to have to go through.
JK
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