1. < Joint Replacements

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.

acolquhoun | @acolquhoun | Aug 31, 2021
In reply to @lynzze "@mrfish A'll of my operations have been done via the posterior incision so I can't really..." + (show)
@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 🙁 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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Hi Lindsay, I am new to the group and just looking through some posts. I hope you are well and I do see that this post was some time ago. My husband is going through a similar issue as yours at the moment. So far, he's had the hip out for a period of 4 months, with now a further 3 months due to infection in his femur. Can you please give me some information on what life without a hip is like, as, at the moment, it looks like this may be a possibility for his future. He's had such a hard time over the last 10 years with recurring infections, I am hoping there's some light at the end of the tunnel.

REPLY
Amanda Burnett | @amandaa | Aug 31, 2021
In reply to @acolquhoun "Following three hip replacements, my husband has now developed a staph aureus infection. He's undergone a..." + (show)
@acolquhoun

Following three hip replacements, my husband has now developed a staph aureus infection. He's undergone a course of antibiotics for 3 months and they've now found that he has infection in his femur. He's now on a 12 week course of antibiotics and hopefully at the end of this, if no infection, they will put a new hip in. Has anyone encountered a similar issue. If the infection doesn't go away, he's been told that he will permanently not have a hip. Can anyone with a similar diagnosis tell me what life is like without a hip - how is your mobility, can you still work and do you still have pain?

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Hi @acolquhoun and welcome to Connect.

I see that you did find this conversation as well. You will see that I moved your post to it so that you could connect with all the people who are having or had similar experiences to your husband like @humbert0, @danagpowell and @bcs123456.

You might also be interested in this discussion:
"If you're living without a hip like me, please reach out to me…" https://connect.mayoclinic.org/discussion/if-youre-living-without-a-hip-like-me-please-reach-out-to-me/

Has he seen an infectious disease doctor yet?

REPLY
1 reply
acolquhoun | @acolquhoun | Aug 31, 2021
In reply to @amandaa "Hi @acolquhoun and welcome to Connect. I see that you did find this conversation as well...." + (show)
@amandaa

Hi @acolquhoun and welcome to Connect.

I see that you did find this conversation as well. You will see that I moved your post to it so that you could connect with all the people who are having or had similar experiences to your husband like @humbert0, @danagpowell and @bcs123456.

You might also be interested in this discussion:
"If you're living without a hip like me, please reach out to me…" https://connect.mayoclinic.org/discussion/if-youre-living-without-a-hip-like-me-please-reach-out-to-me/

Has he seen an infectious disease doctor yet?

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Hi. Yes he’s seen an infectious diseases doctor. They’ve said that a staph aureus infection is one of the hardest to treat. The plan is now to give him another course of antibiotics and more surgery in 4 months to try and replace the hip. It’s been a long process and this has now been 9 surgeries on his leg. I think this is the last option and following this, if the infection is still there, they’ll leave him permanently without a hip. Not sure what this means for all the everyday things you take for granted, ie mobility, employment

REPLY
humbert0 | @humbert0 | Sep 1, 2021
In reply to @acolquhoun "Following three hip replacements, my husband has now developed a staph aureus infection. He's undergone a..." + (show)
@acolquhoun

Following three hip replacements, my husband has now developed a staph aureus infection. He's undergone a course of antibiotics for 3 months and they've now found that he has infection in his femur. He's now on a 12 week course of antibiotics and hopefully at the end of this, if no infection, they will put a new hip in. Has anyone encountered a similar issue. If the infection doesn't go away, he's been told that he will permanently not have a hip. Can anyone with a similar diagnosis tell me what life is like without a hip - how is your mobility, can you still work and do you still have pain?

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I had two replacements due to infection. One was done in Thailand and the infection did not go away. In fact, it manifested itself as a huge weeping abscess on my hip 7 years later. I came to the US and had another surgery in April where an antibiotic spacer was put in and I had a 6 week IV course of Vancomycin, the drug of last resort. My physician told me that the infection builds an impervious layer on the joint that cannot be eradicated by antibiotics. Hip prosthesis removal is required and a prolonged course of strong antibiotics. I doubt the infection will go away without removal of the joint. Oral antibiotics are probably not going to stop the infection.

REPLY
acolquhoun | @acolquhoun | Sep 1, 2021

Hi I hope you are now on the road to recovery and fingers crossed infection free. My husbands doctor has advised us the same. He has had his hip removed for 4 months now, and after finding more infection, have continued to leave the hip out and he is now on a 12 week course of antibiotics to try and beat the infection. We’ve been told that when a new prosthetic is implanted, this becomes a breeding ground for more infection, so the probability of recurrence is high when the hip is put back in. They can’t put a timeline on it. I’m wondering if/ and when this happens, what is mobility like without a hip joint. Thanks

REPLY
1 reply
india65 | @india65 | Jan 16, 2022
In reply to @briank1958 "My situation is not unlike many of those that I have read in this forum. With..." + (show)
@briank1958

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!

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Jan '22 I just found this with my registration to Mayo connect. Is this very old news and BrianK is now doing well? Can I ask - which MAYO was involved with these various MRSA compromised spinal fusion surgeries? I have very similar circumstances but want to know more before I write an epistle on the topic. NPB in NC

REPLY
mima25au | @mima25au | Jan 18, 2022
In reply to @acolquhoun "Hi I hope you are now on the road to recovery and fingers crossed infection free...." + (show)
@acolquhoun

Hi I hope you are now on the road to recovery and fingers crossed infection free. My husbands doctor has advised us the same. He has had his hip removed for 4 months now, and after finding more infection, have continued to leave the hip out and he is now on a 12 week course of antibiotics to try and beat the infection. We’ve been told that when a new prosthetic is implanted, this becomes a breeding ground for more infection, so the probability of recurrence is high when the hip is put back in. They can’t put a timeline on it. I’m wondering if/ and when this happens, what is mobility like without a hip joint. Thanks

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Hello. When i was 25 i had Necrosis a vascular and the doctors tried to save my bone, cutting a bit of bone and adding it to the femur head. It did not worked and it got infected. So the doctor cut my femur head and i was with no femur head 12 months.
After that , i had a successful life with my left hip replacement, the right one is another story 🙁
Asking about mobility if the doctor wont put a temporal hip and you are with no bone like i was, i can tell you that you will be able to do everything but with crotches. Mobility was very good. I used to swim 2 k per day, drive, had a partner, all pretty good. Just being careful of not tripping over that is all.
I hope this helps

REPLY
1 reply
acolquhoun | @acolquhoun | Jan 19, 2022
In reply to @mima25au "Hello. When i was 25 i had Necrosis a vascular and the doctors tried to save..." + (show)
@mima25au

Hello. When i was 25 i had Necrosis a vascular and the doctors tried to save my bone, cutting a bit of bone and adding it to the femur head. It did not worked and it got infected. So the doctor cut my femur head and i was with no femur head 12 months.
After that , i had a successful life with my left hip replacement, the right one is another story 🙁
Asking about mobility if the doctor wont put a temporal hip and you are with no bone like i was, i can tell you that you will be able to do everything but with crotches. Mobility was very good. I used to swim 2 k per day, drive, had a partner, all pretty good. Just being careful of not tripping over that is all.
I hope this helps

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Thank you for your reply. It’s starting to get a bit easier now and things that he couldn’t do before, he’s now managing. Will take time. I hope you are keeping well.

REPLY
cedarrose | @cedarrose | Mar 21, 2022

Severe hyperextension after TKA and spacer revision. Had my initial TKA in early 2020. Recovery seemed to go well but walking was impeded by lumbar disk disease. Hyperextension of the new knee joint set in and a spacer revision surgery was done in May '21. The revision surgery did not seem to be of much benefit and leg is still severely hyperextended. Pain in knee and back wax & wane. Has anyone in this Group experienced this and, if so, can you offer any insights? I'm stumped and am thinking I may just have to learn to live with all of this.

REPLY
cathy19 | @cathy19 | Apr 24, 2022
In reply to @lynzze "@mrfish A'll of my operations have been done via the posterior incision so I can't really..." + (show)
@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 🙁 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

Jump to this post

I’m so sorry what you’ve been through. I’ve had a spacer after remover of infectious hip, if place for 6 months. The plan was the doctor was going to put in a new hip, but suddenly recommended I keep the spacer if PT can help me walk again. I’m so overwhelmed at all the options, and all of the terrible things people have to go through. This has really affected my mental health also. Good luck to everyone!

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