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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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JK | @contentandwell | Jan 5, 2019
In reply to @izabel "Hi @lturn9 . Oh my goodness, things o not seem to be boding well for you..." + (show)
@izabel

Hi @lturn9 . Oh my goodness, things o not seem to be boding well for you at the moment with these disasterous options which you face.

I know what you mean about muscle atrophy and no weight bearing. I am 70 years young and have had my spacer sine 18 October so 11 weeks+ now. As I lost 50 lbs over the last couple of years to take weight off my knees, I went down to 112lbs and should comfortably be 125-130lbs. As a consequence my wrist strength is pathetic, as is my good leg so I am useless at hopping on one foot with the walker. Consequently, I now use a leg energiser at maximum strength for 25 minutes every morning followed by using a peddler. At first I could only do 10 reps backwards but today I am up to 5 minutes going forwards and backwards and as a result have built up the calf muscles in my legs.

I also take Calcium & Vit D (on Surgeon's prescription, B12 and K2 to build up bone density as I have Osteoporosis, and take a probiotic daily. I also take an Omiprazole daily to protect my stomach from the antibiotic and an aspirin to prevent DVT.

I have a 2 inch LLD which hopefully will be resolved when I have the replacement hip.

I hate being in that 1% of unfortunates but as life is giving me lemons, I am trying to make lemonade ... although sometimes it is a little sour!!!!

My thoughts are with you.

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@izabel It sounds as if you are making the best you can of the situation, I applaud you for that. That's great that you are improving your leg strength. I am sure it is a lot of work, but it's worth it.
JK

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1 reply
mzallen | @mzallen | Jan 16, 2019
In reply to @linjane "I really hope the new antibiotics are successful. It's very difficult without a diagnosed pathogen to..." + (show)
@linjane

I really hope the new antibiotics are successful. It's very difficult without a diagnosed pathogen to get the right one. I also hope you have no problems with the new antibiotics. How long will you need to be on them this time? Is it another 6 weeks? Also how often will you have your inflammatory markers checked? Its very frustrating when you are not given the news you want. I really do wish you well please let us know how you get on. Lin x

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@linjane
Hi, just a little update went to see my Id doc last week but he wasn't in the office so I had to meet with his colleague and of course my ESR and CRP levels were still elevated, but this doctor said he doesn't like to go by the ESR and CRP. He said it's best to do an aspiration test and see what comes from that so he said he would talk to my ortho surgeon and see what he says. I did find out Monday morning that they will be stopping antibiotic treatments on the 21st of this month. Hope all is going well with you!!

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2 replies
linjane | @linjane | Jan 17, 2019
In reply to @mzallen "@linjane Hi, just a little update went to see my Id doc last week but he..." + (show)
@mzallen

@linjane
Hi, just a little update went to see my Id doc last week but he wasn't in the office so I had to meet with his colleague and of course my ESR and CRP levels were still elevated, but this doctor said he doesn't like to go by the ESR and CRP. He said it's best to do an aspiration test and see what comes from that so he said he would talk to my ortho surgeon and see what he says. I did find out Monday morning that they will be stopping antibiotic treatments on the 21st of this month. Hope all is going well with you!!

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Yes he is correct ESR and CRP are inflammatory markers that can show up through any inflammatory condition you may have in your body. It may be raised through some other cause not necessarily infection. I had an aspiration in my hip that confirmed my infection it was the next step after an MRI. Stopping your antibiotics might be a good thing as they will show whether there is any change in the CRP or ESR. Aspiration is not that bad just another test once the local is in its ok. Mine was done under ultrasound. This was the definitive test before removal. I'm thinking of you and hope all goes well. Let me know. Lin x

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nursnis | @nursnis | Jan 22, 2019
In reply to @mrfish "@lynzze I expect to have the spacer in there for 2-3 months...and hopefully only once! I'm..." + (show)
@mrfish

@lynzze I expect to have the spacer in there for 2-3 months...and hopefully only once! I'm sorry you've had to go through it so many times. Do they know why you had so many recurring infections? When was the last time you went through it all?

I received some of my pre-surgery paperwork today and was very disappointed to see that my Doc is planning to do the posterior approach to remove the current implant and to place the spacer. Perhaps that's the only way the explant can be done?? I understand that poses a more difficult recovery compared to the anterior approach, which is what I had done for the original hip job last year.

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I had a posterior approach for a new hip 2 yrs ago - It was no problem at all - was golfing in 5 wks - off the cane in 9 days. I personally don't feel there is any difference in anterior or posterior - maybe the Dr. technique makes it different. I am a RN and if you do your homework you'll see why some MDs rather do the posterior hip.

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izabel | @izabel | Jan 24, 2019
In reply to @contentandwell "@izabel It sounds as if you are making the best you can of the situation, I..." + (show)
@contentandwell

@izabel It sounds as if you are making the best you can of the situation, I applaud you for that. That's great that you are improving your leg strength. I am sure it is a lot of work, but it's worth it.
JK

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My SED and CRP levels were within limits last week and I coerced Surgeon in allowing me to touch toe walk with the walker. He wasn't well pleased ... but I have now managed to do 20 mini steps and 8 mins on the pedaler going full rotation. My legs are feeling much stronger and look better (my calfs had resembled turkey necks!). I am still on antibiotics. Next consultation/bloods on 5 February at which time, if bloods are stable, we will discuss Stage 2 ... hurray! I am not getting my hopes up but am trying to be positive on this long journey.

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1 reply
linjane | @linjane | Jan 24, 2019
In reply to @izabel "My SED and CRP levels were within limits last week and I coerced Surgeon in allowing..." + (show)
@izabel

My SED and CRP levels were within limits last week and I coerced Surgeon in allowing me to touch toe walk with the walker. He wasn't well pleased ... but I have now managed to do 20 mini steps and 8 mins on the pedaler going full rotation. My legs are feeling much stronger and look better (my calfs had resembled turkey necks!). I am still on antibiotics. Next consultation/bloods on 5 February at which time, if bloods are stable, we will discuss Stage 2 ... hurray! I am not getting my hopes up but am trying to be positive on this long journey.

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Brilliant news Izabel. They put me on antibiotics following my 2nd stage as a precaution IV Vancomycin for 8 days and then oral for 6 weeks. As we say in England I've got everything crossed for you. Hope you don't have to wait too long. Lin

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1 reply
izabel | @izabel | Jan 24, 2019
In reply to @linjane "Brilliant news Izabel. They put me on antibiotics following my 2nd stage as a precaution IV..." + (show)
@linjane

Brilliant news Izabel. They put me on antibiotics following my 2nd stage as a precaution IV Vancomycin for 8 days and then oral for 6 weeks. As we say in England I've got everything crossed for you. Hope you don't have to wait too long. Lin

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Hi Lin. I actually hope I am kept on them for a while, for good measure! My Surgeon is very conservative, which I prefer to be honest. Where are you now ... just enjoying life?

Here we say tudo cruzado ... but I am from Buckinghamshire, been here 18 years.

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linjane | @linjane | Jan 24, 2019
In reply to @izabel "Hi Lin. I actually hope I am kept on them for a while, for good measure!..." + (show)
@izabel

Hi Lin. I actually hope I am kept on them for a while, for good measure! My Surgeon is very conservative, which I prefer to be honest. Where are you now ... just enjoying life?

Here we say tudo cruzado ... but I am from Buckinghamshire, been here 18 years.

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We are from Wendover in Buckinghamshire! How weird is that. Small world.
I'm ok seeing my consultant next week I feel well but there is always anxiety prior to seeing him. I'm walking well with one stick but can't seem to give this up yet. So Im going for hydrotherapy to see if it can improve it but can get up quite a speed on the walking stick. It's still early days I've only been fully weight bearing for 6 weeks. Think I'm just impatient. Lin x

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mrfish | @mrfish | Jan 24, 2019

@izabel -- what great news to hear your numbers have come down to where they should be and that you're trying your best to get some exercise. It's scary how much atrophy can happen in a relatively short time when you're so limited in what you can do. Of course, the surgery for your second stage will knock your mobility back down again, but the recovery will be that much quicker if you can maintain some (albeit reduced) level of strength and range of motion at this point.

You have the right attitude about being patient with this process. I think the longer you can stick with this stage (even though it's no fun at all), the better overall chances you have at success.

All the best,
Art in Alaska.

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1 reply
izabel | @izabel | Jan 25, 2019
In reply to @linjane "We are from Wendover in Buckinghamshire! How weird is that. Small world. I'm ok seeing my..." + (show)
@linjane

We are from Wendover in Buckinghamshire! How weird is that. Small world.
I'm ok seeing my consultant next week I feel well but there is always anxiety prior to seeing him. I'm walking well with one stick but can't seem to give this up yet. So Im going for hydrotherapy to see if it can improve it but can get up quite a speed on the walking stick. It's still early days I've only been fully weight bearing for 6 weeks. Think I'm just impatient. Lin x

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@linjane Even stranger, We lived in Upton (between Aylesbury and Thame) and I spent a lot of time at Word's End Nurseries, being a lover of gardening, especially exotics. Which hospital are you using? I will be sending good wishes for a positive outcome for you. Do you now have to have blood tests on a regular basis too?

@mrfish Thank you for your support, Art. It is very much appreciated, especially at this stage of the game. People can't imagine what you are going through unless they have experienced this first hand, and I include medical staff! I am fortunate I have not been in pain ... but, then again, when one isn't moving much ....

Izabel xx

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