Anyone who has gone through prosthetic knee joint infection successful

Posted by vinray89 @vinray89, Jul 17, 2023

I had both of my knees replaced by the same surgeon due to debilitating arthritis and pain because my knee joints were both bone on bone. First was the left knee in 2019 and then the right knee in 2020. Had no issues with the left knee that I am aware of, but the right knee has been a complete NIGHTMARE! It all started about a week after the original replacement when I fell on it after trying to stand up from a low seated position. The knee buckled and the incision opened up causing me to have to go in to the hospital for a debridement and re-closing of the incision. Then, things seemed to be fine for almost a year or so. Then in April of 2022 the incision area started to develop some kind of abscess and it eventually broke open and started to drain large amounts of fluid and soft tissue which required another trip to the hospital for another surgery. They went in again and debrided it and swapped out the plastic parts of the joint as well, but this time, they left the incision open after surgery saying it was because there was too much tension on the skin to close it. So I had to have a picc line put in for daily IV antibiotics and wear a wound vac. I was on the IV antibiotics until July of 2022 and then went to taking 600mg of Linezolid oral antibiotics twice a day. I ended up wearing the wound vac for about 6 months because the incision didn't seem to want to heal and close, even though I was under the care of a wound care doctor the whole time who handled the dressing changes and monitored the wound regularly. I would post photos of the wound progression, but they are too gruesome to share here. In any case, the wound was VERY bad and was found to be infected again and this time it was in the joint itself and would require revision to remedy the problem. Since then, I have been to multiple doctors at multiple locations all over the country and I have yet to find anyone willing to do the revision. I have gotten reasons that vary from my being too heavy to the surgery being too difficult or complicated. This has gone on so long now that I am still taking the Linezolid to keep the infection at bay, which has caused me to suffer likely permanent nerve damage and Neuropathy and has put me at extreme risk of having my right leg amputated. I feel that there were multiple mistakes made all through this ordeal. Other surgeons have told me that my surgeon NEVER should have done my replacements at all because of my weight. (Currently and at time of surgeries around 500 lbs. but down from 800 pounds after gastric bypass surgery) Also, I feel as I have surely been discriminated against in my effort to remedy this problem because of my weight. Time is of the essence in this matter to avoid having my leg amputated or possibly even dying from the infection, but thus far, I am the only one making any effort to prevent that outcome.
I have discovered that there is a proven therapy available called "Phage Therapy" that is very successful at eradicating infections of all kinds and reducing the need for multiple surgeries and also the risks that involves. The trouble is, Phage therapy hasn't yet been approved for widespread use in the United States. There aren't many places where it is even available and insurance generally will not cover any treatments that are deemed "experimental". There is at least one case I am aware of that was treated here at Mayo in Rochester. There is a video on YouTube that describes it. The patient's name was John Haverty and he was treated by Dr, Gina Suh with the Mayo infectious diseases department. He had the exact same issue I have, a resistant infection in the right prosthetic knee and was also told that amputation was his only solution, but he didn't give up and finally found Dr. Suh and was treated with Phage therapy successfully and did not have to have his leg amputated. I am hoping for the same outcome in my case, but it is yet to be determined. I am waiting for referrals and records transfers and such. I tried to contact Mr. Haverty to discuss his case and mine, but haven't been able to yet. If anyone else is going through this same thing, feel free to contact me and talk about it. Best of luck.

Interested in more discussions like this? Go to the Infectious Diseases Support Group.

OMgosh, you have really been through it, haven't you. I picked up on your post as I had a post-surgical MRSA and Staph aureus osteomyelitis. I'm wondering if the failure to remove ALL the hardware from your knee was the first problem leading to all others. My infection was caused by a cervical fusion. I needed correction surgery and my ortho replaced all components used in the first surgery. He sent the hardware to pathology to see if grew any bacteria and that is when it was discovered I had MRSA and Staph. These tricky bacteria allow the growth of a biofilm on hardware. That's why I'm wondering if your continued wound worsening is caused by an initial osteomyelitis that has not been completely resolved. I had an friend who was a bit overweight and I know Kaiser refused to do a knee replacement for her unless she lost weight. Easier said then done. Are you diabetic or pre-diabetic? That would include delayed wound healing as well. I'm sure you're tired of those questions. I feel very bad for you facing discrimination which I know is true. My sister is overweight and gets judged all the time. Would your insurance allow you to go to Mayo? I went once and my primary issue was worked up though they also focused on other problems they discovered. In your case I would say you're looking for an infectious disease process. I didn't have a direct referral to Mayo, so you wouldn't need one either (unless its changed). I would encourage you to go this route before you have limited options.

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@sb4ca

OMgosh, you have really been through it, haven't you. I picked up on your post as I had a post-surgical MRSA and Staph aureus osteomyelitis. I'm wondering if the failure to remove ALL the hardware from your knee was the first problem leading to all others. My infection was caused by a cervical fusion. I needed correction surgery and my ortho replaced all components used in the first surgery. He sent the hardware to pathology to see if grew any bacteria and that is when it was discovered I had MRSA and Staph. These tricky bacteria allow the growth of a biofilm on hardware. That's why I'm wondering if your continued wound worsening is caused by an initial osteomyelitis that has not been completely resolved. I had an friend who was a bit overweight and I know Kaiser refused to do a knee replacement for her unless she lost weight. Easier said then done. Are you diabetic or pre-diabetic? That would include delayed wound healing as well. I'm sure you're tired of those questions. I feel very bad for you facing discrimination which I know is true. My sister is overweight and gets judged all the time. Would your insurance allow you to go to Mayo? I went once and my primary issue was worked up though they also focused on other problems they discovered. In your case I would say you're looking for an infectious disease process. I didn't have a direct referral to Mayo, so you wouldn't need one either (unless its changed). I would encourage you to go this route before you have limited options.

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Thank you. It's always nice to find a sympathetic ear. No, I am not diabetic. In fact, I have NO other health issues of any kind, except a mild case of A-Fib that is well controlled with medication. No diabetes, no high blood pressure, no sleep apnea, no asthma, nothing. None of the typical issues that normally accompany being obese. I'm currently in touch with both the ortho and infectious disease departments at Mayo to try and get in to get something done. Just waiting for them to get my medical records as far as I know. I'm sure my insurance will cover most things, but not sure about the Phage therapy, since that is still considered experimental, even after having been around for over 100 years. I am getting referrals from both my regular doctor and the surgeon who did my replacements hopefully. I am still going to continue fighting until I can get something done that doesn't include amputating my leg. At least until I run out of options completely. I remain hopeful.

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