Possible 3rd knee revision surgery w/swelling low-grade infection

Posted by micky19 @micky19, Oct 2, 2019

My husband's left knee develops scar tissue and he can't seem to loosen that knee up. This past year he had a job with a lot of standing and we bought a house and he is doing a lot of outside work. The knee is swelled up and hot, causing him to go to an urgent care ortho office. After x-rays and blood tests, fluid tests, we were told by a ortho dr (not the one who did the original surgery)he recommends remove that device, replace it with an antibiotic block for 8 weeks and put in a new knee. Any one have any luck doing this? He does develop scar tissue in that knee before, still very stiff

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Justin McClanahan, Moderator | @JustinMcClanahan | Oct 8, 2019

Hello @micky19. I'd like to invite @barbwire, @knitpurl1, @szqyoung, @amberpep, and @gutthookd who have all talked about undergoing knee revisions on Connect in the past. I'd also like to share the following discussions with you as well:

Groups > Joint Replacements > Infection after TKR > https://connect.mayoclinic.org/discussion/infection-after-tkr/
Groups > Joint Replacements > What kind of mobility can I expect with an antibiotic spacer in my hip? > https://connect.mayoclinic.org/discussion/what-kind-of-mobility-can-i-expect-with-an-antibiotic-spacer-in-my-hip/ (this discussion is about hip replacements but has lots of members talking about having an antibiotic spacer in a joint after a replacement surgery)

@micky19, you mention in your title that this would be the third revision. Has your husband had issues with infection before that led to a previous revision as well? Has he developed aggressive scar tissue after each surgery?

genespanos | @genespanos | Dec 2, 2021

Sounds like they already took fluid from the knee that came back as infected. Yes. stay the course. Get that 3rd knee when ready. Same here this coming Feb 2022. Gene.

pschoettle | @pschoettle | Aug 7, 2023

My husband had a Total Knee Replacement 8 years ago and has had three revisions due to aseptic loosening (they could never detect any infection despite numerous testing). His last revision included longer posts and more bone cement in the hopes it wouldn't loosen. All looked good until an infection at 5 weeks post surgery. They couldn't do the two phase revision with the antibiotic spacer because of the extreme steps taken to secure the rods and implant. Instead they did the debridement and irrigation. After five months of IV antibiotics and oral antibiotics when he went off the Augmentin the infection returned. Back on the Augmentin until they can switch to a more narrowly focused antibiotic. His surgeon believes the implant will loosen again due to the infection. So now we wait and hope to keep the infection under control until loosening and then a two-stage revision. His surgeon is clearly concerned about all the scar tissue and bone loss from so many surgeries but it sounds like the only other option is an amputation above the knee. Has anyone out there made it through four revisions on a Total Knee Replacement. My husband is 65 and is (or was) an avid hiker and it is heart-breaking to consider his future. Has anyone had any experience with the Phage therapy?

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