Total knee replacement infection after 9 years.

Posted by rguribe @rguribe, Wed, Oct 2 12:36pm

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

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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I am so very sorry you had to go through this. It totally took me by surprise! I thought, aside from premeds for dental procedures, we were all safe from infection, but I guess not. Do they have any idea what caused it? Scary to say the least, especially after 9 years.

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@rguribe I, along with the others, wonder what caused an infection so many years after your TKR. That's something for all of us to be aware of the possibility of it happening. I am about 6 years post TKR on my R knee, and 2 years post TKR on my L knee. I too thought I was out of the woods except for taking an antibiotic before dental procedures. Many orthopedic surgeons don't even suggest that after two years but mine wants me to do it forever.

Looking forward to hearing more from you. I can definitely understand your concern with taking antibiotics forever. I will be interested in hearing what you can find out about that also.
JK

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Did you also have a revision surgery?

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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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Hello Debbra, regarding my infection, I woke up in the morning and I went to step down from the bed and I almost fell down from the pain. I could not walk on it, it was swollen, so I went to the ER. I had no prior symptoms. They drew some fluid from my knee and it was bloody/puss like, and the tests showed an infection. They did emergency surgery the next day. The doctor said that I was fortunate that I did not wait long to get it checked out because the infection could have spread into my bloodstream.

According to the doctor, they cleaned/scrubbed the infected areA, and then they put antibiotic pellets inside the knee before they stitched it up. Unfortunately, they had to put 41 stitches because it was too swollen for just put glue and tape. I now have a pretty nasty scar. I had to be on Vancomycin antibiotic thru a PICC line for 6 weeks which I administered myself twice a day. I lost 20 pounds because the antibiotic took my appetite away, I could barely eat once a day, nausea, dizziness and it killed my stomach, even thou it was administered intravenously.

After 4 months of physical therapy, I am getting better every day. I have to say that this recovery has taken longer and more painful.
The downside is that I have to be on antibiotics for the rest of my life. Oh well, the alternative could have been worse.

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@emb123

I am so very sorry you had to go through this. It totally took me by surprise! I thought, aside from premeds for dental procedures, we were all safe from infection, but I guess not. Do they have any idea what caused it? Scary to say the least, especially after 9 years.

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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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@micky19

Did you also have a revision surgery?

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Fortunately I did not

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@contentandwell

@rguribe I, along with the others, wonder what caused an infection so many years after your TKR. That's something for all of us to be aware of the possibility of it happening. I am about 6 years post TKR on my R knee, and 2 years post TKR on my L knee. I too thought I was out of the woods except for taking an antibiotic before dental procedures. Many orthopedic surgeons don't even suggest that after two years but mine wants me to do it forever.

Looking forward to hearing more from you. I can definitely understand your concern with taking antibiotics forever. I will be interested in hearing what you can find out about that also.
JK

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I am researching taking antibiotics for the rest of my life, but I have found/gotten mixed responses from doctors/websites. I am making an appointment with Mayo clinic to discuss this further. Unfortunately, I have taken great amount of antibiotics for past illnesses thru the years and so it is of great concern.

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@rguribe Thank you for explaining what happened. What a nightmare you went through! It’s a good lesson for all of us to get medical care quickly, things could have been much worse.

It’s a cautionary lesson too. I am sure many of us may have skipped washing our hands at some point when we should have. Those of us who are post-transplant so on immunosuppressants need to be especially careful. It’s very surprising that it could have even been inhaled.
JK

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@rguribe

Hello Debbra, regarding my infection, I woke up in the morning and I went to step down from the bed and I almost fell down from the pain. I could not walk on it, it was swollen, so I went to the ER. I had no prior symptoms. They drew some fluid from my knee and it was bloody/puss like, and the tests showed an infection. They did emergency surgery the next day. The doctor said that I was fortunate that I did not wait long to get it checked out because the infection could have spread into my bloodstream.

According to the doctor, they cleaned/scrubbed the infected areA, and then they put antibiotic pellets inside the knee before they stitched it up. Unfortunately, they had to put 41 stitches because it was too swollen for just put glue and tape. I now have a pretty nasty scar. I had to be on Vancomycin antibiotic thru a PICC line for 6 weeks which I administered myself twice a day. I lost 20 pounds because the antibiotic took my appetite away, I could barely eat once a day, nausea, dizziness and it killed my stomach, even thou it was administered intravenously.

After 4 months of physical therapy, I am getting better every day. I have to say that this recovery has taken longer and more painful.
The downside is that I have to be on antibiotics for the rest of my life. Oh well, the alternative could have been worse.

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Oh my gosh @rguribe – my heart is just aching for you. I cannot imagine the trauma you've been through with this. I've been on Connect for awhile now and I can truthfully say that I haven't heard of anyone getting an infection so far out of surgery. You must've been in shock when they told you what it was. I was so glad to hear that you have an appointment at Mayo to discuss the implications of antibiotics for life. Can you ask the doctor point-blank what the possible side affects are and whether there are alternatives? Also, can you keep us posted? You can see that there are many of us who have had TKR's who are closely following your situation and interested in the answers you get.

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@contentandwell

@rguribe Thank you for explaining what happened. What a nightmare you went through! It’s a good lesson for all of us to get medical care quickly, things could have been much worse.

It’s a cautionary lesson too. I am sure many of us may have skipped washing our hands at some point when we should have. Those of us who are post-transplant so on immunosuppressants need to be especially careful. It’s very surprising that it could have even been inhaled.
JK

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I would agree, and find your experience alarming. I am relieved you sought treatment so promptly. It is an important reminder of the need for vigilance with hand washing etc. Thankyou for sharing, it’s a timely reminder

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