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

@boislandgirl

I had both knees replaced about 10 years ago. I developed an infection In my right knee about 6 years later. I had cellulitis in my chin and the infection traveled to my knee. My doctor told me that sometimes an infection in one place (my chin) will travel to places where there is an artificial part…in this case my right knee. It started hurting about 2 weeks after the cellulitis and my knee was hot, red, and swollen. The first time I went to the ER they gave me pain meds. I followed through by seeing my surgeon several day later. At this point he put me on an antibiotic and was simply watching it. By 2 weeks it was so swollen and painful I could hardly stand it.
I went in to see the doctor and he removed some fluid and sent it for testing. I received a phone call from his office several hours later telling me to go to the hospital and check in, they had a room for me. They said he would be surgically removing the infected tissue, etc. They called it “debride and irrigate” the area. This was surgery #1. I woke up with a “soft immobilizer ” which kept me from bending my knee. I was also on IV antibiotics. I stayed in the hospital several days and the moved to rehab. I was on antibiotics for several months. I recovered and things were fine.
#2 Surgery- About 5 months later I fell in the garage. I whacked my knee, broke 3 ribs, and broke 3 vertebrae above where I had titanium rods in my Lumbar spine. Boy, I was a mess and in terrible pain. Back to the hospital….the fall caused the infection in my knee to kick up again. As my luck would have it I had MRSA. Apparently minute pieces (cells) of the infection can linger on the artificial parts. So all the hardware in my knee was removed. A cement block saturated with antibiotics was placed in that area and once more I was on antibiotics. Before I left the hospital I had a PICC line inserted and for several months I administered the antibiotics through the PICC line. It must have been about 6 months before Infectious Diseases cleared me for surgery #3 to give me new hardware.
At this point I was turned over to a Reconstruction Specialist. He put in my new hardware. And I was still on antibiotics…he said most likely I would need to take them forever. I had another PICC line and more antibiotics again. This time the brace was an immobilizer that went from ankle to the highest possible area of my thigh. My incision was 27 inches! After 3 months I got to remove the brace.
I was doing great except my kneecap seemed to be off center a bit. Within a month or so, my kneecap worked it’s way almost to the side of my leg. So surgery #4 was done to move my kneecap over and “tied” in place. Back to the killer brace. Passed go and the brace came off. It wasn’t long before my kneecap started moving around to the side. So…
You guessed it, Surgery #5! My own tendon was shot. My doctor said it was like elastic that have been stretched too far and lost it’s elasticity. This time I had a bone graft, a new patella, and a new tendon that connected to what was left high in my thigh. I was doing great, getting around fairly well while wear my brace that allowed no bending. I also developed another infection, but it was quickly attacked by more antibiotics.
I know you will find this unbelievable but there was Surgery #6! The bone graft started to separate so he went back in and used larger screws and wrapped wire around it so it wouldn’t separate. I am now about 2 months post surgery from the last surgery. I have to wear the brace for another 3 months-making 6 in total. Two weeks ago I fell but no damage to my knee! My back is a different story.
But after all this covering about 3 years, I can see the light at the end of this tunnel. I am taking Minocycline, maybe forever and another antibiotic for the small infection I had at the end. I have that lovely 27 inch incision scar but it is funny what really matters. I don’t care what my leg looks like. I just want to be able to walk, drive, and enjoy life. I think I am close to doing those things again. Long trip but I am still positive and look forward to living again. Sometimes I cannot believe my own story. What I have discovered it that there are so many nice and caring people out there. Male, female, every age, everyone stops to help me through a door or in and out of a chair, etc. it gives me hope for the world. And I so appreciate my group of family and friends who have done so much to help keep me going. I have been fortunate indeed.

Jump to this post

Hello @boislandgirl, Welcome to Mayo Clinic Connect. Thank you for sharing your story of staying positive under some really scary and bad circumstances. I had my right knee replaced a year ago in April and I cannot imagine what you have been through. Sharing your experience will be beneficial to many members on Connect.

You mention you have had a lot of support from your family and friends to keep you going. Do you have any tips to share with others who may be struggling with infection and knee replacements?

REPLY

That is disturbing – am sorry to hear of the infection. Just a question: My 1st TKR surgeon said take 2000 MG Amoxicillin for lifetime before any intrusive dental work (including quarterly periodontal cleaning/gum maintenance).
My 2nd TKR surgeon said take it for 2 years. Do you mind my asking if your surgeon or dentist recommended this and if they think dental work could have caused your infection? Thank you and best wishes.

REPLY

I have read that. Not sure. Will C in Saint Charles, MO

REPLY
@tennisgolf

That is disturbing – am sorry to hear of the infection. Just a question: My 1st TKR surgeon said take 2000 MG Amoxicillin for lifetime before any intrusive dental work (including quarterly periodontal cleaning/gum maintenance).
My 2nd TKR surgeon said take it for 2 years. Do you mind my asking if your surgeon or dentist recommended this and if they think dental work could have caused your infection? Thank you and best wishes.

Jump to this post

My dentist requires it! I don’t even have to remember. In the past, if I have forgotten, the dentist has it in house. And yes, I have to take it forever before dental work. I would follow the advice of your dentist as this is their field. I take antibiotics all the time because of the infection. It has not been decided as to whether or not this is forever. And, no, dental work did not cause the infection. I had cellulitis in my chin and the infection eventually traveled to my knee and the hardware. My own opinion is that when I went to the ER because of the cellulitis, as I had a small open sore in my chin, I also picked up the other infection.
I have been to the dentist twice since the infection and before the last 2 surgeries, I took the extra antibiotic and had no problems. I will add that my husband had a shunt in his head and he was required to take the antibiotics.
Perhaps your dentist and your physician could have a conversation and come up with the best plan for you. Thank you for asking and best wishes to you!

REPLY

Yes, I have been through that…twice! I will be on antibiotics until forever it seems. Having been through the infection twice, removal of hardware, replacement of hardware, and a couple of tendon reconstructions, if taking the antibiotics means I never have another infection, I will do so gladly.

REPLY

I too got an infection in my left TKR 2 years after surgery. The infection did not present with any pain or swelling in the knee. One day I became confused and disoriented, then unconscious, I was rushed to the ER and diagnosed with sepsis. The doctor told my wife if she did not call the paramedics when she did I would have been dead in a couple of hours. I presented with renal, respiratory and heart failure and I was on a ventilator for 3 weeks, flat lined twice. The surgeon removed the knee hardware and put in two spacers. I spent 2 months in the hospital, had a second surgery to clean out the area and replace the spacers. The surgery left me with a 10 cm by 6 cm open wound. I am currently on a Wound Vac to hopefully heal the wound from the inside out. I am on antibiotic infusion balls 3 times a day for 6 weeks. The surgeon doesn't know if the knee can be replaced.

This experience has been a nightmare for me and my family. We are thinking of taking legal action? Has anyone taken legal action?

Mike M. Port Charlotte, FL

REPLY

Hello @mgm15 and welcome to Mayo Clinic Connect. I am so sorry to hear of your horrendous experience. I can see that you are looking to connect with others who have had infections following a total knee replacement and to see if anyone else has taken legal action. I am not personally aware of anyone in this discussion who have, however, there could be.

While we wait for other members, have you been successful at both confirming the infection was a direct result of your surgery and have other providers who have indicated on record that as well?

REPLY
@amandajro

Hello @mgm15 and welcome to Mayo Clinic Connect. I am so sorry to hear of your horrendous experience. I can see that you are looking to connect with others who have had infections following a total knee replacement and to see if anyone else has taken legal action. I am not personally aware of anyone in this discussion who have, however, there could be.

While we wait for other members, have you been successful at both confirming the infection was a direct result of your surgery and have other providers who have indicated on record that as well?

Jump to this post

Thank you for your reply. I can confirm the infection was in my left TKR. The surgeon pulled puss from the knee, then removed the infected hardware.
The reason I am looking for legal action is I am facing needing medical care for the rest of my life. I have to find out the manufacturer of the artificial knee to see if there has been any recalls. There are several manufacturers that have been thousands of law suits due to the recalls.

REPLY
@boislandgirl

I had both knees replaced about 10 years ago. I developed an infection In my right knee about 6 years later. I had cellulitis in my chin and the infection traveled to my knee. My doctor told me that sometimes an infection in one place (my chin) will travel to places where there is an artificial part…in this case my right knee. It started hurting about 2 weeks after the cellulitis and my knee was hot, red, and swollen. The first time I went to the ER they gave me pain meds. I followed through by seeing my surgeon several day later. At this point he put me on an antibiotic and was simply watching it. By 2 weeks it was so swollen and painful I could hardly stand it.
I went in to see the doctor and he removed some fluid and sent it for testing. I received a phone call from his office several hours later telling me to go to the hospital and check in, they had a room for me. They said he would be surgically removing the infected tissue, etc. They called it “debride and irrigate” the area. This was surgery #1. I woke up with a “soft immobilizer ” which kept me from bending my knee. I was also on IV antibiotics. I stayed in the hospital several days and the moved to rehab. I was on antibiotics for several months. I recovered and things were fine.
#2 Surgery- About 5 months later I fell in the garage. I whacked my knee, broke 3 ribs, and broke 3 vertebrae above where I had titanium rods in my Lumbar spine. Boy, I was a mess and in terrible pain. Back to the hospital….the fall caused the infection in my knee to kick up again. As my luck would have it I had MRSA. Apparently minute pieces (cells) of the infection can linger on the artificial parts. So all the hardware in my knee was removed. A cement block saturated with antibiotics was placed in that area and once more I was on antibiotics. Before I left the hospital I had a PICC line inserted and for several months I administered the antibiotics through the PICC line. It must have been about 6 months before Infectious Diseases cleared me for surgery #3 to give me new hardware.
At this point I was turned over to a Reconstruction Specialist. He put in my new hardware. And I was still on antibiotics…he said most likely I would need to take them forever. I had another PICC line and more antibiotics again. This time the brace was an immobilizer that went from ankle to the highest possible area of my thigh. My incision was 27 inches! After 3 months I got to remove the brace.
I was doing great except my kneecap seemed to be off center a bit. Within a month or so, my kneecap worked it’s way almost to the side of my leg. So surgery #4 was done to move my kneecap over and “tied” in place. Back to the killer brace. Passed go and the brace came off. It wasn’t long before my kneecap started moving around to the side. So…
You guessed it, Surgery #5! My own tendon was shot. My doctor said it was like elastic that have been stretched too far and lost it’s elasticity. This time I had a bone graft, a new patella, and a new tendon that connected to what was left high in my thigh. I was doing great, getting around fairly well while wear my brace that allowed no bending. I also developed another infection, but it was quickly attacked by more antibiotics.
I know you will find this unbelievable but there was Surgery #6! The bone graft started to separate so he went back in and used larger screws and wrapped wire around it so it wouldn’t separate. I am now about 2 months post surgery from the last surgery. I have to wear the brace for another 3 months-making 6 in total. Two weeks ago I fell but no damage to my knee! My back is a different story.
But after all this covering about 3 years, I can see the light at the end of this tunnel. I am taking Minocycline, maybe forever and another antibiotic for the small infection I had at the end. I have that lovely 27 inch incision scar but it is funny what really matters. I don’t care what my leg looks like. I just want to be able to walk, drive, and enjoy life. I think I am close to doing those things again. Long trip but I am still positive and look forward to living again. Sometimes I cannot believe my own story. What I have discovered it that there are so many nice and caring people out there. Male, female, every age, everyone stops to help me through a door or in and out of a chair, etc. it gives me hope for the world. And I so appreciate my group of family and friends who have done so much to help keep me going. I have been fortunate indeed.

Jump to this post

Your complications sound unbelievable.
First of all my husband was in the hospital for 3 days Sept 26 with pneumonia
He had a knee replacement Oct 27, 2020. First day great going up and down stairs making progress. Day 3 excruciating pain.
Aspiration showed no infection. However his pain was intolerable. Nov 7 went back in with a wash out. Treated as if infected. vancomycin through picc. And Cefepine. Rehab then home. Positive Covid 19. Elevated kidney creatinine level due to too high dosage of vancomycin. Back for another 2 week hosp stay. Blood Clots. Tested neg for Covid 19.
Home now with
6 different medications twice a day
Way behind in PT
Creatinine still elevated
Blood clots. ?
Oxygen. Due to low level. Dips to below 90
Very tired.
No appetite.
Nausea

This has been a nightmare for a 78 year old man who played 18 holes of golf the day before the first surgery. It’s going to be a long road back to anything resembling normal.

REPLY

Praying for a speedy recovery.

REPLY
@mgm15

I too got an infection in my left TKR 2 years after surgery. The infection did not present with any pain or swelling in the knee. One day I became confused and disoriented, then unconscious, I was rushed to the ER and diagnosed with sepsis. The doctor told my wife if she did not call the paramedics when she did I would have been dead in a couple of hours. I presented with renal, respiratory and heart failure and I was on a ventilator for 3 weeks, flat lined twice. The surgeon removed the knee hardware and put in two spacers. I spent 2 months in the hospital, had a second surgery to clean out the area and replace the spacers. The surgery left me with a 10 cm by 6 cm open wound. I am currently on a Wound Vac to hopefully heal the wound from the inside out. I am on antibiotic infusion balls 3 times a day for 6 weeks. The surgeon doesn't know if the knee can be replaced.

This experience has been a nightmare for me and my family. We are thinking of taking legal action? Has anyone taken legal action?

Mike M. Port Charlotte, FL

Jump to this post

mgm15…
What happened to you is mortifying to me. So you did not have any pain or swelling in your knee but you were incredibly ill. This concerns me because in 2018 I had a knee replacement and I have been having a lot of burning in my knee lately. This makes me wonder if I should see the orthopedist about this. I don't think that we are told enough about what the ramifications can be from TKR surgery.

I am so sorry that you have had to go through this nightmare and I hope that your wound heals very quickly.

Katrina123

REPLY
@katrina123

mgm15…
What happened to you is mortifying to me. So you did not have any pain or swelling in your knee but you were incredibly ill. This concerns me because in 2018 I had a knee replacement and I have been having a lot of burning in my knee lately. This makes me wonder if I should see the orthopedist about this. I don't think that we are told enough about what the ramifications can be from TKR surgery.

I am so sorry that you have had to go through this nightmare and I hope that your wound heals very quickly.

Katrina123

Jump to this post

Katrina. Yes after 1 day of normal post op pain in knee, then pain became unbearable. That is why the aspiration was done 9 days after the first surgery. That aspiration did not show infection but to be on the safe side the orthopedic surgeon decided to treat it as an infection. My husband was not able to put any weight on that leg. I had to call 911 to get him back to hosp for second surgery. He could not get out to the car.

REPLY
Please sign in or register to post a reply.