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

Wow and here I thought I was alone... Since August of 2017 Ive had 8 hip surgeries. 5 Hip replacements. 4 Hip spacers. 4 PICC Lines. The 5th hip was looking good then after the 10th day a hematoma bursted and of course I got sepsis. 104.5 temp is no fun. On March 4th 2019, they removed my 5th hip and decided I needed a year off. So I have no left hip at all and can walk somewhat with a 3 inch lift on the bottom of my left shoe. The ups and downs are not fun. I have almost normal blood work. CRP 11 sed is 40. They check me monthly and monthly the number decrease. I feel somewhat normal at the moment. I was always fatigued with the infections. Plus the Vanco twice a day is no fun. All we can do is fight the good fight.

That other appointment with the head of the department, a 60 year old surgeon, is on 6/26. Both surgeons are extremely qualified but the older gentlemen has been around the block a few more times. As I am trying to gain a little more perspective on both flavors of the surgery I guess my end goal is to feel better about the 2-stage process and get a little more than a hint of living with the spacer for 4 to 8 weeks. Quite frankly, reading everyone's posts is a little scary. Not from the idea of living with the spacer but that, in their case, the infection keeps coming back. Yikes!!! From what I have read there is a 15% chance that will happen, even under the best of circumstances. Many thanks for all your kind words and the huge amount of confidence you have thrusted upon me. Of course I will keep you posted! Brian

My situation is not unlike many of those that I have read in this forum. With that being said I am looking for some specific answers that I have yet to receive from my surgeon. First, my situation is that I have gone through 11 surgeries. On the orthopedic side I have had a knee replaced, both hips replaced and a joint on a big toe replaced. All of the replacements are made of surgical grade titanium. In addition I've had 4 spinal fusions so I am fused from the L1 thru the L5. My problems started in the spring of 2018 with 2 staph bacteria's and MRSA. It is not known at this time where I picked up the bacteria. They tell me it could have laid dormant in my left hip since 2007 but this can't be verified.

In the early part of last summer they put me in the hospital for a week and sent me home with a PICC line for another 6 weeks of antibiotics. Cultures showed everything was good by August 1st. By mid-October I became delusional, delirious and despondent (the 3 D's as I call them). They rechecked my blood with cultures and found massive amounts of staff and MRSA. They checked my hardware in my back and found it to be positive as well. My only option was to have all the hardware removed. I spent 2 months in the hospital and another 2 weeks in a rehab center. I came home right at Christmas this past year.

My rehab at home went well as I was relearning how to walk but by the end of February I started to get pains in my left hip. 2 doctors told me it was probably bursitis from all the PT I was doing. Wrong! My infectious disease doctor did more cultures and I had an aspiration done on the hip. By early April my back was now getting sore. What I have been told now is that my left prosthetic hip and my psoas muscles are now infected with the same bacteria as I had before. They say my only option is to have the left rip replaced and drains put in. The 1st surgeon I saw said he would only do a 2-stage replacement with a cement, antibiotic-laden spacer. The length of this spacer being in my hip is still not known. My surgeon won't even consider a 1-stage replacement because of the MRSA. The 1st of the stages is scheduled on July 11th. I do have an appt. with a much older, and hopefully more experienced surgeon from the same group towards the end of this month to get a second opinion to see if he might consider the less-invasion 1-stage replacement.

The questions I am putting out here are 1) Does anyone have any personal information on the success rate of the 1-stage replacement? Studies I've found on the internet show only a slightly less success rate for the 1-stage replacement. 2) I am obviously not new to surgeries but I am new to this 2-stage procedure. Just how bad is it? 3) Will I be able to get around the house on my own, I.E. going to the bathroom and going up stairs with the spacer in my hip?

My infectious disease Dr. says that the staph and MRSA bacteria that is in my body is a very mutated and antibiotic resistent strain and is going to be very hard to irradicate thoroughly and completely. He also says the likelihood of it ending up back in the same hip or any of the other 3 prostetic joints is not only possilbe but at this time is probable. This is despite the replacement of my left hip, being on Vancomycin both in the hosital and going home with a PICC line and even being on an oral antibiotic for the rest of my life. My problems with this are seemingly endless.

Hopefully someone can answer a few of my questions and can offer some pertinent advise. Many thanks to all who respond!

@briank1958 I hear you! I am a mentor and I almost quit this group as I was approaching my TKR date because it was so scary reading about the potential problems. I'm glad I stayed! Just remember, most people come on here with big hearts and hopes - trying to get information about problems they are experiencing. It's kind of rare to read about someone saying how well things went and how easy their recovery has been. (I wish they would!) I believe there are two reasons they don't. First, they are busy doing their lives and they don't login; and second, they don't want to "brag" and make people who aren't doing so well feel like they are behind. So... I'm counting on you to log back in and tell us how well your visit goes on 6/26 and what terrific results you get. I'm pulling for you.

I’m responding to the request for comments on tkr’s that have gone well. I wasn’t on Mayo Connect before my surgery in 2013 and had no idea of the possible complications. I had cortisone shots for maybe 3 years prior and tried the gel shots until nothing was helping anymore. My recovery was uneventful with gradual relief from pain, swelling, etc. The doctor said I have optimum results with full rom and I’ve told him that it’s the best thing I’ve done. Since then I’ve also had a kidney transplant which also fits into that category. I have to be honest... if I was aware of all of the possible problems I’ve read about here, it would have scared me to death.

Hello @mrfish,

Welcome to Connect. thank you so much for sharing your information; we're glad you've joined us.

We have a few discussions on Connect where members have talked about total hip replacement, infection and spacers:
– Walking without a hip joint https://connect.mayoclinic.org/discussion/walking-without-a-hip-joint/
– End of stem pain after total hip replacement https://connect.mayoclinic.org/discussion/end-of-stem-pain-after-total-hip-replacement/
– THR, Anterior Approach - 3 week mark https://connect.mayoclinic.org/discussion/thr-anterior-approach-3-week-mark/

@kenman @geek_girl @lynzze @hip2012 @mnpat @grandmacheryl @popolopo @sma1952 @leigh60 @amber67, would you join me in welcoming @mrfish, and share your experiences?

My situation is not unlike many of those that I have read in this forum. With that being said I am looking for some specific answers that I have yet to receive from my surgeon. First, my situation is that I have gone through 11 surgeries. On the orthopedic side I have had a knee replaced, both hips replaced and a joint on a big toe replaced. All of the replacements are made of surgical grade titanium. In addition I've had 4 spinal fusions so I am fused from the L1 thru the L5. My problems started in the spring of 2018 with 2 staph bacteria's and MRSA. It is not known at this time where I picked up the bacteria. They tell me it could have laid dormant in my left hip since 2007 but this can't be verified.

In the early part of last summer they put me in the hospital for a week and sent me home with a PICC line for another 6 weeks of antibiotics. Cultures showed everything was good by August 1st. By mid-October I became delusional, delirious and despondent (the 3 D's as I call them). They rechecked my blood with cultures and found massive amounts of staff and MRSA. They checked my hardware in my back and found it to be positive as well. My only option was to have all the hardware removed. I spent 2 months in the hospital and another 2 weeks in a rehab center. I came home right at Christmas this past year.

My rehab at home went well as I was relearning how to walk but by the end of February I started to get pains in my left hip. 2 doctors told me it was probably bursitis from all the PT I was doing. Wrong! My infectious disease doctor did more cultures and I had an aspiration done on the hip. By early April my back was now getting sore. What I have been told now is that my left prosthetic hip and my psoas muscles are now infected with the same bacteria as I had before. They say my only option is to have the left rip replaced and drains put in. The 1st surgeon I saw said he would only do a 2-stage replacement with a cement, antibiotic-laden spacer. The length of this spacer being in my hip is still not known. My surgeon won't even consider a 1-stage replacement because of the MRSA. The 1st of the stages is scheduled on July 11th. I do have an appt. with a much older, and hopefully more experienced surgeon from the same group towards the end of this month to get a second opinion to see if he might consider the less-invasion 1-stage replacement.

The questions I am putting out here are 1) Does anyone have any personal information on the success rate of the 1-stage replacement? Studies I've found on the internet show only a slightly less success rate for the 1-stage replacement. 2) I am obviously not new to surgeries but I am new to this 2-stage procedure. Just how bad is it? 3) Will I be able to get around the house on my own, I.E. going to the bathroom and going up stairs with the spacer in my hip?

My infectious disease Dr. says that the staph and MRSA bacteria that is in my body is a very mutated and antibiotic resistent strain and is going to be very hard to irradicate thoroughly and completely. He also says the likelihood of it ending up back in the same hip or any of the other 3 prostetic joints is not only possilbe but at this time is probable. This is despite the replacement of my left hip, being on Vancomycin both in the hosital and going home with a PICC line and even being on an oral antibiotic for the rest of my life. My problems with this are seemingly endless.

Hopefully someone can answer a few of my questions and can offer some pertinent advise. Many thanks to all who respond!

I’m responding to the request for comments on tkr’s that have gone well. I wasn’t on Mayo Connect before my surgery in 2013 and had no idea of the possible complications. I had cortisone shots for maybe 3 years prior and tried the gel shots until nothing was helping anymore. My recovery was uneventful with gradual relief from pain, swelling, etc. The doctor said I have optimum results with full rom and I’ve told him that it’s the best thing I’ve done. Since then I’ve also had a kidney transplant which also fits into that category. I have to be honest... if I was aware of all of the possible problems I’ve read about here, it would have scared me to death.