Total knee replacement infection after 9 years.

Posted by rguribe @rguribe, Oct 2, 2019

I recently had an infection on my total knee replacement, they went in and clean the infected area. I was on 6 weeks of Vancomycin antibiotics through a PICC line, and afterwards, the doctor stated that I would have to be on a low dose of antibiotics (Doxycycline 100mg) for the rest of my life, that it was the new recommendation from the AMA. I have not been able to find that info in the AMA website and my concern is the side effects of taking antibiotics for the rest of my life. Has anybody gone thru a similar infection and is presently on antibiotic for the rest of their life? Thank you

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@avb1085

I can relate. I’ve had three surgeries since January. First was a TKR that got infected after five weeks. The second was a partial revision, but the infection didn’t go away. The third took out everything and put in a spacer until the infection goes away. I am now awaiting a test to see if it’s gone and they will schedule the fourth TKR. This will be 4 surgeries in 5 months. It really has sucked to be me this year, but you’re not alone. Let’s both hang in there!!!

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I am 45 and have had my spacer since october 19th 4 surgeries up until then but i have other complications with platelets and anemia but numbers are improving. hang in there as well you are in my prayers we can beat this!!!

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they are talking about that when i get my new implant in. currently i have been taken off antibiotics
and if i fight infections off naturally i will get implant and lifetime antibiotics. hang in their your in my prayers

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@aleznek

HI.. thanks to a doctor doing a bad job, at 47, I had my first knee replacement., he only did a partial, because "I was so young".. needless to say, three weeks later another doctor had to put in a full replacement, and 9 surgeries later, I now have a bad infection also.. this is over an 8 year span. I was told today when I went to see a dr on an emergency time visit (I see the knee dr on Tuesday) because I have been in such pain. I thought it was the starting of a Bakers Cyst because of the swelling and lump. The dr said no because there was nothing there to cause that. He told me that IF I had an infection (did the blood work and the two tests, for infection came back high) he said that what would happen would be that I would have to have emergency surgery, they would go in and take out the fake knee, but some kind of block in so that the knee would not bend until the infection went away, then do another (3rd) replacement. I broke down and started to cry..

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i am not going to lie. the spacer is no fun as i have had one in since october it is painful causws swelling and wont bend i am 6'2" tall and cannot fit in a car i have to ride in back of ou SUV lying on my back. you also cannot put weight on it if you only have it a few months it won't be too bad. you are in my prayers

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Hi, I have partial knee replacements (2018, 2019, 2020) and still use antibiotics for dental work, dermatology biopsies, pedicures, colonoscopies, etc. I recently cut my leg gardening and took some the next day, and have been wondering if I should have at least called and asked my surgeon. No visible signs of infection, but ....
I did a search about the topic and it gave me your post on this blog. How are you doing now (June 2023)? Well, I hope.
Also, a low daily dose of doxycycline is a commonly prescribed treatment for dermatology issues, especially rosacea or adult acne/excessive oiliness--even a daily normal dose of bactrim, or sometimes minocycline, is pretty common, in my experience and research.

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@marieltha

Hi, I have partial knee replacements (2018, 2019, 2020) and still use antibiotics for dental work, dermatology biopsies, pedicures, colonoscopies, etc. I recently cut my leg gardening and took some the next day, and have been wondering if I should have at least called and asked my surgeon. No visible signs of infection, but ....
I did a search about the topic and it gave me your post on this blog. How are you doing now (June 2023)? Well, I hope.
Also, a low daily dose of doxycycline is a commonly prescribed treatment for dermatology issues, especially rosacea or adult acne/excessive oiliness--even a daily normal dose of bactrim, or sometimes minocycline, is pretty common, in my experience and research.

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My primary, ortho and both of my dentists agree on prophylactic antibiotics even though some of the literature says they are not necessary. When I get garden, hiking or garage cuts, I take a dose right away. My primary makes sure I always have 3 mega-doses on hand. The only bad news is that after over 15 years, my body decided amoxycillin was not for me, and I had to change to another broad-spectrum.
Sue

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Your protocol sounds excellent. I always take some if there is any exposure to anything that might infect.
Every time I took fluoroquinolone antibiotics (levaquin, cipro, etc) I experienced tendon injuries, so I cannot take any of those. So for the prophylactic doses I just use the amoxicillin.

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I developed an infection in 6 year old replacement. I have had 2 surgeries so far--infection came back. Also picc line and total of 12 weeks iv antibiotics. Dr says he may have to put me in a brace for 6 weeks to get total extension. Does anyone have a similar situation?

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Hello @robinchats, I moved you discussion and combined it with a discussion titled, Total knee replacement infection after 9 years - https://connect.mayoclinic.org/discussion/total-knee-replacement-infection-after-9-years. I did this so you could meet members like @rguribe, @djm, and @ammaw52 who discussed antibiotics after knee replacement or a device to straighten their leg.

@robinchats, I had my knee replaced at a young age due to a genetic bleeding disorder (hemophilia) and severe arthritis caused by internal bleeding episodes as a child. I had aggressive scar tissue formation and underwent two manipulations followed by a leg brace that had cranks to straighten and bend the knee. The brace helped, but I also believe some of my poor recovery was due to the fact that I was 19 at the time and not as diligent about my PT as I would be say I had the surgery now.

@robinchats, Are you past your infection at this point? If you are going to be in a brace for 6 weeks, is it one that only keeps your knee extended, can you remove it so you don't loose flexion as well?

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@rguribe

The doctors told me that it could have been as simple as inhaling germs from someone that had a bad cold around me and/or from a minor cut were bacteria entered my bloodstream. Medical procedures (surgeries, ect) can also cause it if germs enter your bloodstream. They also said that it could have taken months after the germ(s/bacteria) attached themselves to the metal parts of the replacement, for it to grow and spread to the tissue (muscle/tendon ect) within the knee, that's when the infection spreads and your body reacts.

I am now very cautious when I do any kind of work, I wear gloves, will definitely clean any kind of cut that I may get to prevent future infections (I was really bad at that), even thou being on antibiotics is suppose to help from now on.

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Do or did you smoke?

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@debbraw

Hi @rguribe - Welcome to Connect. That is so scary that you developed an infection 9 years later. I've had 2 TKR's - one in 2017 and one earlier this year. I never dreamed that an infection could develop after so many years. You must have been devastated. My doctor has told me I have to take antibiotics before teeth cleaning for the rest of my life, but its just 4 amoxicyllin ever 6 months so it's not the same as your situation. While we are waiting for others to chime in, can you tell me what the rest of your recovery was like? Were there extenuating circumstances or did this kind of hit you out of the blue?

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So sorry to hear about the infection. The first TKR I was advised to take amoxicillin for teeth cleanings the most recent TKR in Jan 2023 the new surgeon advised antibiotics no longer necessary. Does anyone have the same experience?

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