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.

Liked by lynzze

@linjane

Hi Neka. Nice talking to you. I should have waited wait 6 weeks and had low CRP and ESR before they proceeded. This indicated that the infection in the tissues surrounding the device were free from infection. I had to wait longer as I couldn't get an operating slot. The surgeon then took swabs at the surgery all of which were still positive for Staph Caprae. (You cannot eradicate the infection on the biofilm of the device once it's there. This will continue to reinfect if not treated). Once the device was out I was given Vancomycin twice a day until the swabs taken during the op came back negative. They didn't! They came back showing another potential staph infection. My microbiologist felt it was a contaminent as it didn't show for 10 days. So I had to have another 6 weeks of oral antibiotics. I feel well for the first time since the initial hip replacement went in and this is what reassures me. The infection had made me very anaemic and had affected my liver and kidneys. The recent blood tests show this is now correcting. There really is nothing you can do but have trust in your surgeon I have to say mine is a brilliant man. I just class myself as unfortunate this has happened to me. I really wish you well please let me know how you are. Lin x

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@linjane I was taking three different antibiotics at first vancomycin, rosephin, and ranvampyn. I hope I spelled them correctly…lol, but I started having a reaction to vancomycin and the rosephin, and the ranvampyn (which was an oral antibiotic). So they took me off the vancomycin and rosephin. And replaced it with ranvampyn in iv form, and teflero. I'm just hoping they cleared the infection, because this spacer is very uncomfortable and painful. I've had the spacer in now since November 7

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@mzallen

@linjane I was taking three different antibiotics at first vancomycin, rosephin, and ranvampyn. I hope I spelled them correctly…lol, but I started having a reaction to vancomycin and the rosephin, and the ranvampyn (which was an oral antibiotic). So they took me off the vancomycin and rosephin. And replaced it with ranvampyn in iv form, and teflero. I'm just hoping they cleared the infection, because this spacer is very uncomfortable and painful. I've had the spacer in now since November 7

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I can sympathize completly looking back and its still early days for me so mobility is not all as I would like it but I'm getting there. The spacer is an evil instrument of torture! Can you weight bare at all? I just realised I was also on oral Rifampacin with the Vancomycin! When I left hospital they stopped the Vancomycin and switched it to Teicoplannin which is once a day.The drugs you talk about are very powerful and broad spectrum. it's just a shame you don't know what infection you are fighting as you could have definitive confidence that they are the right ones. This is a waiting game for us all and every stage is full of angst. You must have confidence and positivity and if your inflammatory markers are decreasing take hope from that. I'm sending all the positivity I can. Please let me know how you get on. Lin x

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@linjane

Hi Neka. Nice talking to you. I should have waited wait 6 weeks and had low CRP and ESR before they proceeded. This indicated that the infection in the tissues surrounding the device were free from infection. I had to wait longer as I couldn't get an operating slot. The surgeon then took swabs at the surgery all of which were still positive for Staph Caprae. (You cannot eradicate the infection on the biofilm of the device once it's there. This will continue to reinfect if not treated). Once the device was out I was given Vancomycin twice a day until the swabs taken during the op came back negative. They didn't! They came back showing another potential staph infection. My microbiologist felt it was a contaminent as it didn't show for 10 days. So I had to have another 6 weeks of oral antibiotics. I feel well for the first time since the initial hip replacement went in and this is what reassures me. The infection had made me very anaemic and had affected my liver and kidneys. The recent blood tests show this is now correcting. There really is nothing you can do but have trust in your surgeon I have to say mine is a brilliant man. I just class myself as unfortunate this has happened to me. I really wish you well please let me know how you are. Lin x

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I am really stunned hearing about people getting staph infections from a joint replacement. I think if I had known this before my two knee replacements I may not have had them and just lived in pain. Does anyone know the percentage of people who end up having to go through this?
JK

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@contentandwell

I am really stunned hearing about people getting staph infections from a joint replacement. I think if I had known this before my two knee replacements I may not have had them and just lived in pain. Does anyone know the percentage of people who end up having to go through this?
JK

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Hi JK. The figure I was given was less than 1% for hips. Many of the staff on the orthopaedic ward I was on had never nursed anyone that had had my procedure. I have no idea for knee but I seem to that this may be higher but don't quite me. You are one of the lucky ones. Lin

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@linjane

Hi JK. The figure I was given was less than 1% for hips. Many of the staff on the orthopaedic ward I was on had never nursed anyone that had had my procedure. I have no idea for knee but I seem to that this may be higher but don't quite me. You are one of the lucky ones. Lin

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@linjane Thanks, Lin. I guess you are right, I am one of the lucky ones. This is absolutely frightening. My brother-in-law just had a hip replacement and he is doing great also. I do know many people who have had either hip or knee replacements and none of them have gone through this, so I suppose it must be a small percentage, but it sounds like an absolutely terrible thing to have to go through.
JK

Liked by linjane

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@linjane well I jjust got back from the doctors office and unfortunately my levels aren't low enough so I have to continue with my antibiotic treatments.

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We'll keep you in our prayers!

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@contentandwell

I am really stunned hearing about people getting staph infections from a joint replacement. I think if I had known this before my two knee replacements I may not have had them and just lived in pain. Does anyone know the percentage of people who end up having to go through this?
JK

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I don't know if doctors would share that number or not. I have a staph infection as well and am taking Keflex. They said Vanco would not be necessary in this case but I may be on Keflex forever. My options are really limited. This is Knee #4 on my left knee and with each replacement the surgeon trims the bones so the prothesis will fit. At the moment my left leg is almost 3" shorter than the other. They tell me one option, if the infection gets worse, (and so far is doesn't seem to be getting better) would be to remove the joint, and replace my good hip with an artificial one, then run a straight rod to my ankle so my leg would never bend. The other choice is amputation. I was improving and was getting close to walking without the walker until I got a DVT near the prosthesis. Since then I have lost more and more feeling in my leg. But JK, you are right to be concerned, and the hospitals seem to go far to minimize the risk but people still get infections. Having to live with a Spacer is a life changing event IMO. I had one for 8 weeks with no load bearing and at 67 my muscles atrophy quickly and are slow to return. I feel as you do about the risk – if I knew then, what I know now, I would never, ever consider getting a joint replacement.

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@lturn9

I don't know if doctors would share that number or not. I have a staph infection as well and am taking Keflex. They said Vanco would not be necessary in this case but I may be on Keflex forever. My options are really limited. This is Knee #4 on my left knee and with each replacement the surgeon trims the bones so the prothesis will fit. At the moment my left leg is almost 3" shorter than the other. They tell me one option, if the infection gets worse, (and so far is doesn't seem to be getting better) would be to remove the joint, and replace my good hip with an artificial one, then run a straight rod to my ankle so my leg would never bend. The other choice is amputation. I was improving and was getting close to walking without the walker until I got a DVT near the prosthesis. Since then I have lost more and more feeling in my leg. But JK, you are right to be concerned, and the hospitals seem to go far to minimize the risk but people still get infections. Having to live with a Spacer is a life changing event IMO. I had one for 8 weeks with no load bearing and at 67 my muscles atrophy quickly and are slow to return. I feel as you do about the risk – if I knew then, what I know now, I would never, ever consider getting a joint replacement.

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@Iturn9 I'm so sorry your going through this I pray they don't have to amputate your leg. I'm 36 and I'm starting to wish I would have waited as well

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@mzallen

@linjane well I jjust got back from the doctors office and unfortunately my levels aren't low enough so I have to continue with my antibiotic treatments.

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Oh Neka I'm so sorry. Have they decreased at all? Maybe you just need a little more time. Sending love and hope. Lin

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@linjane

Oh Neka I'm so sorry. Have they decreased at all? Maybe you just need a little more time. Sending love and hope. Lin

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@linjane yes they have decreased some but not enough. The doctor said next week they will be starting me on stronger antibiotics. Thanks for the prayers I really appreciate it, I will also pray for you all

Liked by linjane

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@mzallen

@linjane yes they have decreased some but not enough. The doctor said next week they will be starting me on stronger antibiotics. Thanks for the prayers I really appreciate it, I will also pray for you all

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Hello @mzallen and welcome to our small unique group. I am sorry to hear your infection has not cleared and that in fact your levels have risen. I hope the new antibiotic is successful for you.

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@lturn9

I don't know if doctors would share that number or not. I have a staph infection as well and am taking Keflex. They said Vanco would not be necessary in this case but I may be on Keflex forever. My options are really limited. This is Knee #4 on my left knee and with each replacement the surgeon trims the bones so the prothesis will fit. At the moment my left leg is almost 3" shorter than the other. They tell me one option, if the infection gets worse, (and so far is doesn't seem to be getting better) would be to remove the joint, and replace my good hip with an artificial one, then run a straight rod to my ankle so my leg would never bend. The other choice is amputation. I was improving and was getting close to walking without the walker until I got a DVT near the prosthesis. Since then I have lost more and more feeling in my leg. But JK, you are right to be concerned, and the hospitals seem to go far to minimize the risk but people still get infections. Having to live with a Spacer is a life changing event IMO. I had one for 8 weeks with no load bearing and at 67 my muscles atrophy quickly and are slow to return. I feel as you do about the risk – if I knew then, what I know now, I would never, ever consider getting a joint replacement.

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Hi @lturn9 . Oh my goodness, things o not seem to be boding well for you at the moment with these disasterous options which you face.

I know what you mean about muscle atrophy and no weight bearing. I am 70 years young and have had my spacer sine 18 October so 11 weeks+ now. As I lost 50 lbs over the last couple of years to take weight off my knees, I went down to 112lbs and should comfortably be 125-130lbs. As a consequence my wrist strength is pathetic, as is my good leg so I am useless at hopping on one foot with the walker. Consequently, I now use a leg energiser at maximum strength for 25 minutes every morning followed by using a peddler. At first I could only do 10 reps backwards but today I am up to 5 minutes going forwards and backwards and as a result have built up the calf muscles in my legs.

I also take Calcium & Vit D (on Surgeon's prescription, B12 and K2 to build up bone density as I have Osteoporosis, and take a probiotic daily. I also take an Omiprazole daily to protect my stomach from the antibiotic and an aspirin to prevent DVT.

I have a 2 inch LLD which hopefully will be resolved when I have the replacement hip.

I hate being in that 1% of unfortunates but as life is giving me lemons, I am trying to make lemonade … although sometimes it is a little sour!!!!

My thoughts are with you.

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@mzallen

@linjane yes they have decreased some but not enough. The doctor said next week they will be starting me on stronger antibiotics. Thanks for the prayers I really appreciate it, I will also pray for you all

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I really hope the new antibiotics are successful. It's very difficult without a diagnosed pathogen to get the right one. I also hope you have no problems with the new antibiotics. How long will you need to be on them this time? Is it another 6 weeks? Also how often will you have your inflammatory markers checked? Its very frustrating when you are not given the news you want. I really do wish you well please let us know how you get on. Lin x

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@lturn9

I don't know if doctors would share that number or not. I have a staph infection as well and am taking Keflex. They said Vanco would not be necessary in this case but I may be on Keflex forever. My options are really limited. This is Knee #4 on my left knee and with each replacement the surgeon trims the bones so the prothesis will fit. At the moment my left leg is almost 3" shorter than the other. They tell me one option, if the infection gets worse, (and so far is doesn't seem to be getting better) would be to remove the joint, and replace my good hip with an artificial one, then run a straight rod to my ankle so my leg would never bend. The other choice is amputation. I was improving and was getting close to walking without the walker until I got a DVT near the prosthesis. Since then I have lost more and more feeling in my leg. But JK, you are right to be concerned, and the hospitals seem to go far to minimize the risk but people still get infections. Having to live with a Spacer is a life changing event IMO. I had one for 8 weeks with no load bearing and at 67 my muscles atrophy quickly and are slow to return. I feel as you do about the risk – if I knew then, what I know now, I would never, ever consider getting a joint replacement.

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Hello lturn9. I'm so sorry to hear what you have been going through. This sounds horrendous makes me feel really lucky! My leg was 2 inches shorted before they replaced my hip and I'm so happy to say my legs are now the same length. I'm 59 but my muscles atrophied even with partial weight bearing quite quickly with my spacer. I have to say now I'm fully weight bearing it hasn't been as easy as I hoped to get moving again. My back and knees have been incredibly painful but I'm pleased to say that's settling and I'm beginning to see the light at the end of a very long tunnel. Did you not have an anticoagulant to prevent DVT? I think I'm lucky, as Izobel I appreciate you've had it hard to not be able to walk at all, that would really get me down. I really do feel for you. I wish all of us the best of luck it's about time we all deserve a break. It just seems when you are down your kicked an awful lot with this condition. I agree wholeheartedly with your lemons analogy Isabel. That made me laugh. Keep strong. Lin x

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