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.

@tooyoung

Thank you for your quick response and the concern you've shown!
What I hoped to find here was that I am not alone but it seems like my experience is esoteric... Not that any of us can ever fully understand what the next user is going through, I hoped that soomeone might be able to give me an idea of WHY mine is so problematic/painful and perhaps give me advice going forward!
I do have a ludicrous amount of anxiety/depression, but I feel like it comes directly from this pain and its consequent life changes and limitations.
And as far as the chronic pain group, it's hard for me to accept that so many people have thr's and have minimal pain afterwards and feeling like I will have chronic, lifelong, excruciating pain bc my docs won't do a thr!
I apologize, it seems I'm as lost and misguided here as I am in all of life! I'm just so tired of falling between the cracks!
Again. I'm sorry! If you'd like me to take down my story, I understand...

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Although there are many doctors and ways to attempt dealing with the variety of chronic pain conditions mentioned on this forum; I have occasionally found it helpful to reach out to a therapist to focus on ways to process my emotions associated with living with chronic illness......at those times, I feel like there is a weight temporarily lifted...and then I leave therapy for years and am able to manage, advocate for medical services in way too many ways to start to even describe, and continue to rely on strategies to promote calmness in my life, along with being able to sustain some minimal relationships and even a little fun! Then, the cycle seems to start again.....but we all seem to have a human condition and feeling grateful for what I do have seems to go a long way in going through each day...however they unfold.....

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@lturn9

You said you "have a ludicrous amount of anxiety/depression". My observations during the 20+ years I have had PN, is that mood is very responsible for increases in pain levels. From frustration (for any reason) to stress, and any other types of mood, can all increase pain levels dramatically. There have been times when I had reduced levels of stress and had reduced levels of pain as well. When the stress comes back, the pain comes back. You also said " I'm as lost and misguided here " indicates you need to find some help in managing your life in general. Also, please don't apologize when telling your story and don't feel you need to take your story down; your experiences are as important as anyone else's here and we want to hear about your experiences so we can try to help you. We are here to help you deal with your PN by providing insight into our combined experiences in how we all deal with this disease on a daily basis. Regarding the THR you would like. I am sorry, but I don't know what a THR is, but if you feel it will help you control your pain and PN, find a different Dr. There are a huge number of medical professionals out there and each one has a different way of treating each problem they try to help patients deal with. If needed, go to a different Doc, try a specialist such as a Anesthesiologist. Also find a doc to talk to about your Anxiety/depression and your feeling of feeling lost and misguided. Your nervous system is complex and a part of every part of your body. Finally, some people have found help in their church. Letting God into your life can have dramatic results for some people. Please maintain participation in this group (or another like it if you prefer) but don't bottle everything up and please know we're all in this together and will help you as much as possible. Keep us informed about your status.

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Omg thank you for your extraordinary kindness! My PT was jst talking to me about the effects my negativity could be having on my pain and to be honest, I don't know anymore! It's been 15 yrs-my entire adult life (first the 80+ terrifying ER visits before endometriosis diagnosis then 40+ post-diagnosis). I'm starting to feel like my whole life is a shit show lol
I DO apologize for my incessant apologies, it's jst that my entire life it's been drilled into my head I'm nothing but a "burden, a disappointment and a failure" so whenever anyone even suggests I'm doing something wrong, is second nature for me to accept defeat and shut down...yet another problem I'm aware of but if it keeps being proven, how do I change my way of thinking?
For example, even though my surgery was mid 8/18, I just came to a nursing home in that beginning of Sept (meds, suicide watch, previous experience w a nursing home was very negative, my severe pain and the level of care are all reasons they gave me for it taking so long)! They didn't get my pain under control until my 16th mo in the hosp! Before then I'd just cling to the bedrail and cry and moan, I gave up on ever having a life! But after, my pain was at a tolerable lvl and I progressed like lightning! I was still depressed (who wldnt be after all that time in a hosp, losing everything w no friends or familial support?) But I'd begun to believe I cld have at least part of my normal life back! I was even proud of myself some days! But when I got here, they cut my pain meds in half AND cut my anxiety med completely! Without even seeing the Dr! I stayed in bed 8days, not eating, screaming bloody murder every time I moved, it was horrific! So they effectively took all my progress (mental and physical) and washed it away w one swipe of a pen (/stroke on a keyboard)! I saw the Dr during that time, he sd I'd "get used to it" and left me! Then, finally on that 8th day I saw a nurse practitioner who agreed to give me half of the meds they took and space it out two more hrs Bc I told her I read the nursing home rules and regulations and they're not supposed to halt your progress, much less cause regression and my plan was to report them to the health dept for noncompliance on the advice of my health ins rep!
So! I've been spinning my wheels, doing things I was doing 6 mos ago at the hospital, struggling to make a bit of progress, when ask of a sudden, they told me last Fri that if I didn't make some huge improvement Monday that they were going to cut me from the rehab program and move me to a long term bed! After only 45 days here, with the improper tools (it'd be ok with me if they DIDN'T give me my meds bk, but manage my damn pain SOMEHOW)! But instead the Dr comes in for 30secs when I've just fallen asleep and tells me I'll "get used to it?!" How can they punish me for me not being able to stand the torture enough to progress with the absolute minimal tools?! It's like telling Monet to create a masterpiece with a box of 8 store brand crayons that've been used, broken and are barely functional! I WISH. I cld drag my leg without such intense pain! I'm 35 fit Christ's sakes, its not like i Want to be crippled forever!
And a THR is a total hip replacement! I understand there are many more ortho surgeons out there but dealing with finding a Dr has been overwhelming as heck to me since my health probs started! I know it's something I'm going to have to do if I ever get out of here though so I'm trying to work up nerve! I only hope that that cycle is finally broken and I find one dr who doesn't treat me like I'm an annoyance to them...
I know I'm too emotional y'all... I can't help it! I used to be better at hiding it but now I'm physically crippled so I might as well show my emotional crippling too!
I DO sincerely appreciate ANY feedback, advice, anything but tough love lol and if you suggest something and I say "I tried that but..." Please don't think I'm discounting your advice, I'm just telling you MY experience in hopes that maybe you can help me work around...my fear/experience...? Make sense?

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@mrfish

@tooyoung, right after I got my spacer the pain was excruciating, like nothing I'd ever experienced before. Unfortunately, it took my ortho a few days to realize just how bad it was for me, but fortunately he brought in an anesthesiologist who put in a pain block (sorry, I'm not sure if that's the correct term). It was a small tube that gradually released a local anesthetic at/near a my spine which gave me immediate relief (so I was also tethered to the IV bag and its pump). I think I had that for about three weeks. I still had moderate pain from the spacer after that was removed, but it was nothing like what I experienced at first. I don't know if maybe a nerve was damaged in the surgery to put in the spacer, or what, but it helped get me "over the hump". Good luck, I hope you can address your pain and eventually get the spacer out and a new THR.

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thank you for sharing your experience and your support!
I'm not sure if my ortho was a butcher or what but my femural head crumbled when he took it out of socket. Maybe his roughness is what's causing so much residual pain for me? Either that or the septic arthritis/the fact they allowed the mrsa to damage that area for 9 mos before spacer placement...? I died on the table and wasn't woken up for six days afterwards but it sounds like a nerve (I thinthat's the right terminology for it)/pain block wldve been a godsend! For me the pain has only lessened for an off the charts to a ten usually only upon movement, moments of little or no support, when sitting on a hard surface or when my leg is held too high after a few months! They say long term opiate use can change the way your body feels pain too, so it's a catch 22! It really is! I don't feel like I deserve to suffer anymore... Its to the point where my chest hurts bad every day before pt bc I'm jst so certain that TODAY is going to be the day where I feel just one more iota of pain than usual and I'm going to go totally irreparably insane! Again, not normal, but what I'm learning about experience w spacers is that no two are the same, and just like w my endometriosis, the lvl of pain is impossible to measure, which sucks! I was recently denied for disability and its like "who's kept in the hospital for 22mos if they're not disabled?!" All bc they can't just put a stamp on me and say "ok, she has a antibiotic spacer, stress disabled," but in the meantime, I'm in this damn nursing home rotting away, losing more and more of myself everyday... What's a girl to do?!

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@kanaazpereira

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:
ā€“ Walking without a hip joint https://connect.mayoclinic.org/discussion/walking-without-a-hip-joint/
ā€“ End of stem pain after total hip replacement https://connect.mayoclinic.org/discussion/end-of-stem-pain-after-total-hip-replacement/
ā€“ 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?

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I'm 2 months out from having a spacer in. I had 4 prior hip replacements and the last one got MRSA. I went through the course of antibiotics and feeling good. Almost no pain. Today I had a CT and the radiologist noted a fluid build up around the head of the spacer. Is this something that I should be concerned about?

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@coonhound

I'm 2 months out from having a spacer in. I had 4 prior hip replacements and the last one got MRSA. I went through the course of antibiotics and feeling good. Almost no pain. Today I had a CT and the radiologist noted a fluid build up around the head of the spacer. Is this something that I should be concerned about?

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Hi I'm Lin from the UK I had my spacer in my R. Hip for staph Caprae June 2018.
Don't panic just yet it could just be some oedema after all you have been through a lot. What are your inflammatory markers doing? They would need to culture some of that fluid to see if there was infection present. Have you spoken to your Dr yet? In this country radiographers are not allowed to comment on scans xrays etc incase it worries the pt, thats the Drs job who usually will then discuss a plan with you. Good luck. Let us know how you get on. .

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<p><strong>Spacer P. O.Ā </strong></p><p>I'm 2 months out from having a spacer put in. I've had 5 hip surgery and 4 replacements. My last got infected with MRSA. Not having much pain. I can mobilize OK. I had a CT scan today and it showed a fluid build up around the head of the spacer. Is this something that I should be concerned about?</p>

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@coonhound Two months ago you had a "spacer put in." You had a CT scan and it showed that you had fluid buildup. You are wondering if you should be concerned?

You will notice that I moved your question to a previous discussion related to hip spacers. I did this so you could connect with members like @debbraw @cmael @contentandwell @linjane in a central location. You may want to scroll through the previous posts in search of information, suggestions, and support.

Below I have linked a related discussion where members @sueinmn @perryl @breick @palmsprings59 @hopalongnm3 @popolopo @lotsofpain are currently discussing hip replacements.
- Total hip replacement - What to expect for recovery https://connect.mayoclinic.org/discussion/total-hip-replacement/

May I ask when your next appointment is to go over the CT results?

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@erikas

@coonhound Two months ago you had a "spacer put in." You had a CT scan and it showed that you had fluid buildup. You are wondering if you should be concerned?

You will notice that I moved your question to a previous discussion related to hip spacers. I did this so you could connect with members like @debbraw @cmael @contentandwell @linjane in a central location. You may want to scroll through the previous posts in search of information, suggestions, and support.

Below I have linked a related discussion where members @sueinmn @perryl @breick @palmsprings59 @hopalongnm3 @popolopo @lotsofpain are currently discussing hip replacements.
- Total hip replacement - What to expect for recovery https://connect.mayoclinic.org/discussion/total-hip-replacement/

May I ask when your next appointment is to go over the CT results?

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I'm sorry, @erikas and @coonhound but I know nothing about hip spacers and have never had a hip replacement, just two knees.
JK

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@coonhound I feel for you, I had 5 surgeries (three joint replacements, one spacer, and one wash-out). Are they going to try to draw out some of that fluid for a culture? I see @linjane already covered that and it may be hard to get anything to culture since the spacer is typically coated with antibiotic-impregnated cement, but there might be value to trying.

After my initial hip replacement but before I had my spacer put in, they noticed fluid around the joint and ordered a procedure to draw some of the fluid out (aspiration) to be cultured. This could help them (1) determine if there's actually an infection and (2) identify the organism causing the infection and, if need be, adjust your antibiotics to better target it. When they drew out fluid from my joint, unfortunately someone screwed up badly and they didn't get the sample to the lab soon enough and it couldn't be cultured. So they scheduled me for a second aspiration but they couldn't get any fluid that time. It wasn't until my next to last surgery that they were finally able to get a positive ID from a culture and specifically identify what was causing the infection. Once they got that ID'd, they did one more THR to swap out with clean hardware (that was three years ago, this March), put me on different antibiotics and things have been good for me since then.

I wish you the best of luck!
Art in Alaska

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@lynzze

@mrfish A'll of my operations have been done via the posterior incision so I can't really say if anterior is easier or not. I haven't really had issues with that approach, although, because I have had sooo many surgeries the muscle in the side of my leg/butt is virtually gone which causes me to limp more. But I didn't really have an option lol
They never pinpointed the exact reasoning behind my reacurrant staph infections other than possibly not all the infection was completely gone out of my body when the replanted. Luckily when #4 got infected I went to Mayo clinic and they advised everything being removed and leaving nothing implanted for at least 1 year. That was a hard pill to swallow. A hanging hip is no fun and the recovery process is crazy. My surgeon also advised I try to go more than a year ...he said the longer you go without staph the better chances of a successful #5. Knowing that #5 would be the last one (I'm running out of good femur) (did I mention I'm only 35 lol this has been going on for 12 years ...all a result of an automobile accident) I wanted to do everything possible to make it a success. I made it 4.5 years without a hip or spacer !! It wasn't easy however I'm happy to say I recieved my hail Mary #5 hip June of 2016 and have had no infection (so far)!!!! I'm beyond happy although now the darn thing won't stay in place lol
I have dislocated #5 3 times now šŸ™ so that's no fun...2 of the dislocations required surgery. Funny enough it just dislocated last weekend so I just got home from mayo where I had surgery to repair and change a few components ... Thankfully the recovery process isn't bad so I'm doing well.
My case is definitely rare and I draw a lot of attention from amazed orthopedists when I'm at Mayo lol I'm kind of a guinea pig and up to try anything new they have available to make this darn thing work lol
I really hope your surgery goes smooth... Do your pt exercises (even though I was resistant , I know they work lol)
If you have any more questions I am here!!
Lindsay with 5 hips lol

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Wow, Iā€™m impressed with your tenacity.
I am currently recovering from my fourth hip infection/replacement. During my recent February 5th revision surgery of my right hip, it was decided that all of the parts would be removed and the antiseptic spacer would be installed and there are no plans to replace the antiseptic spacer with a permanent device . We are all under the belief that the longer that I can go without another surgery, the better. Close monitoring of the hip via frequent x-rays will be in my immediate future.
God Bless
Any advice/suggestions would be appreciated.

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