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

Last week I finished the 6 weeks of IV cefazolin and had my PICC line removed. Yay! No more wrapping my arm in saran wrap to shower. Now, 6 more weeks of rifampin and levaquin pills. It built up gradually over about two weeks, but late last week I had a terrible bout with c diff (tested positive). Dang, I thought the pain w/ hip spacer was bad…the cramping from c diff put that to shame. So, now I also have vancomycin pills to hold c diff in check and will probably have to stay on those until finished with the other antibiotics. Fortunately, the vanc pills only took about 24 hours to get rid of the abdominal pain.

Physical therapy has been going very well, and I'm VERY glad to say that this weekend I finally quit using my cane. Since November 15, I've had to use either a walker, crutches or a cane. I still have a bit of a wobble to my walk, but I'll keep working on that at PT. Things are well so far, but I won't really know if I have this beat until I'm off the antibiotics for a while. Thanks and my very best positive thoughts to you all!

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Hello – so good to hear from you but not about the difficulties you have been having, I've had a bout of c diff years ago so can remember how miserable that can be. Your body has been a real battleground for such a long time, I'm truly hoping that the antibiotics are successful in getting rid of every last bit of infection. And congratulations on being free from crutches, a walker and a cane. That is a real victory

I had my THR on April 10 – two weeks ago. There was no sign of infection but a culture is being grown to see if anything shows up. My Infectious Disease doc put me on the antifungal medicine Fluconozale for at least three months just to be safe. The side effects are quite uncomfortable. But I don't ever want to go through this again so will trust his direction.

I am on six weeks of non weight-bearing to allow my hip to heal. I had full mobility with the use of my walker so the restricted mobility is difficult. Back to the walker and a wheelchair. Pain from the hip replacement is more than what I expected but tolerable with pain meds, I'm headed in the right direction!

Wishing you the best!

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@janelaine

Hello – so good to hear from you but not about the difficulties you have been having, I've had a bout of c diff years ago so can remember how miserable that can be. Your body has been a real battleground for such a long time, I'm truly hoping that the antibiotics are successful in getting rid of every last bit of infection. And congratulations on being free from crutches, a walker and a cane. That is a real victory

I had my THR on April 10 – two weeks ago. There was no sign of infection but a culture is being grown to see if anything shows up. My Infectious Disease doc put me on the antifungal medicine Fluconozale for at least three months just to be safe. The side effects are quite uncomfortable. But I don't ever want to go through this again so will trust his direction.

I am on six weeks of non weight-bearing to allow my hip to heal. I had full mobility with the use of my walker so the restricted mobility is difficult. Back to the walker and a wheelchair. Pain from the hip replacement is more than what I expected but tolerable with pain meds, I'm headed in the right direction!

Wishing you the best!

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Thanks @janelaine. I'm glad to hear your THR is going well so far. I think I'm seeing treatment options much the same as you, after what I've been through, I'm not nearly as concerned about medical side effects from antibiotics as I am with finally getting rid of this once and for all. Levaquin, one of my new oral meds, apparently has serious risks of joint damage…and I was strongly urged by my infectious disease doc to discontinue that med immediately if I experienced any new joint pain (I am being very conscious of this aspect, but no problems so far). He also said I'd probably need to stay on the vancomycin pills to hold down c diff, my thoughts were like "if two antibiotics are good, three are better!"
Hang in there! Being able to move forward from using each assistive device was always a big victory, but I feel ditching the walker for the cane and/or crutch was the biggest of all (even more so than leaving the cane to walking unassisted).

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@mrfish

Last week I finished the 6 weeks of IV cefazolin and had my PICC line removed. Yay! No more wrapping my arm in saran wrap to shower. Now, 6 more weeks of rifampin and levaquin pills. It built up gradually over about two weeks, but late last week I had a terrible bout with c diff (tested positive). Dang, I thought the pain w/ hip spacer was bad…the cramping from c diff put that to shame. So, now I also have vancomycin pills to hold c diff in check and will probably have to stay on those until finished with the other antibiotics. Fortunately, the vanc pills only took about 24 hours to get rid of the abdominal pain.

Physical therapy has been going very well, and I'm VERY glad to say that this weekend I finally quit using my cane. Since November 15, I've had to use either a walker, crutches or a cane. I still have a bit of a wobble to my walk, but I'll keep working on that at PT. Things are well so far, but I won't really know if I have this beat until I'm off the antibiotics for a while. Thanks and my very best positive thoughts to you all!

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@mrfish sorry to hear about the c diff issues and I haven't been on here this year because I actually spent December-March at Mayo Clinic with my 5th infected hip ;( but I am back home now and I am so happy to hear things are going relatively well for you!! I bet you are more than happy to not have that spacer in anymore?!?!?! They aren't fun but they are better than not having hardware at all lol keep me updated on your progress and I am happy you are walking without an assistive device!!!

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@janelaine

Hello – so good to hear from you but not about the difficulties you have been having, I've had a bout of c diff years ago so can remember how miserable that can be. Your body has been a real battleground for such a long time, I'm truly hoping that the antibiotics are successful in getting rid of every last bit of infection. And congratulations on being free from crutches, a walker and a cane. That is a real victory

I had my THR on April 10 – two weeks ago. There was no sign of infection but a culture is being grown to see if anything shows up. My Infectious Disease doc put me on the antifungal medicine Fluconozale for at least three months just to be safe. The side effects are quite uncomfortable. But I don't ever want to go through this again so will trust his direction.

I am on six weeks of non weight-bearing to allow my hip to heal. I had full mobility with the use of my walker so the restricted mobility is difficult. Back to the walker and a wheelchair. Pain from the hip replacement is more than what I expected but tolerable with pain meds, I'm headed in the right direction!

Wishing you the best!

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@janelaine so glad to hear your new hip is doing well!!!! Non weight bearing status is so hard to do but it is extremely beneficial when you have had problems in the past. I am also glad your ID doctor is doing the 3 month antibiotic regimen…it helped me more than once. Your pain is probably more intense because this is not the first time they have been in their messing around. I can't remember were you a hip spacer or no hip?? Praying for complete healing for you and hopefully this hip is the best one!!!!!!

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Thanks for your encouragement. Yes, I had a spacer put in in November because of a fungal infection. My THR was done on April 10. recent lab work shows my CRP numbers are creeping back up so I will definitely be on the antifungal Medicine with all its nasty side effects for the foreseeable future. no weight-bearing is very difficult although I am almost three weeks post-op and can start partial weight-bearing in tgree more weeks. The pain is bad and i’m being tapered off pain pills which I know is necessary but hard. I just want my life back. This has gone on for a year and I am tired and discouraged even though the end seems to be so close. I am thankful for the support of family and friends.

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@janelaine is this your 2nd THR? 3rd? Did the same surgeon do both? Mayo Clinic?? Sorry just curious lol My last infection was fungal VRE. The previous 4 infections were all staph or MRSA. Surprisingly the VRE fungal infection took me the longest to get rid of. I really hope they are able to save your new hip!!! It's so stressful and trying to go through it time and time again. My story is a rare one because I actually had 5 THR (over the course of 12 years) fail to infection and when they took #5 out I was no longer a candidate for future THRs. If for some reason this hip fails for you and you are not a current Mayo patient I encourage you to check into getting an appointment with them. They really are amazing and gave me every possible chance for success….my body just had other plans.

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My first THR was six years ago. So this is my second THR. The Doctor Who did my surgery staudied at Mayo clinic and is foremost in the field. I have not had any bacterial infections They did take a culture on April 10 to check for anything else. It takes four weeks for that to grow out. The quick culture that they did during surgery showed no signs of fungus infection so I’m hoping it can be controlled by the Antifungal medicine before it reaches the hip. I have a top-notch infectious disease Doctor Who is really on top of this. Thanks for your input good luck

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Quick update: I finished my 3-month course of antibiotics about one month ago. I also ended my PT sessions about 6 weeks ago. My right hip/leg is probably at about 98%. I feel good about how things are going, but I don't think I'll begin to relax until I get 3 months past the antibiotics.

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I made it to my 3-month anniversary last week (finishing antibiotics) and within just a couple of days I think it's back (and, of course, it shows up on a Friday evening so I can't get in to see my infectious disease doc until Monday). If I need to go through it all again, I think I need to consider something different. @lynzze, you and others have recommended getting into a Mayo facility, where did you go? I see there's a facility in Scottsdale, AZ (and it's in-network with my insurance). The idea of extended travel for this worries me, but there's that saying about the definition of insanity…

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@mrfish

I made it to my 3-month anniversary last week (finishing antibiotics) and within just a couple of days I think it's back (and, of course, it shows up on a Friday evening so I can't get in to see my infectious disease doc until Monday). If I need to go through it all again, I think I need to consider something different. @lynzze, you and others have recommended getting into a Mayo facility, where did you go? I see there's a facility in Scottsdale, AZ (and it's in-network with my insurance). The idea of extended travel for this worries me, but there's that saying about the definition of insanity…

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Hi! I’m new to this Mayo Clinic connect. I was searching for living with an antibiotic spacer and mobility expectations when I came across your original post back in November 2017. I’ve been looking at this thread and I see you’re quite far in your journey. I’m so sorry the infection appears to be back. I just had surgery in May at the Mayo Clinic in Rochester Minnesota. I’m from Texas. I lived with my staff infection for about 4 1/2 years on suppressive therapy (Bactrim 1 pill a day) when I saw a sought a second opinion from the infectious disease and orthopedic surgeon at the Mayo. I traveled with my mom and we took our two small dogs with us. We knew we would be there for at least the six weeks of IV antibiotic treatment after I got my spacer put in. I rented a small house through Home Away that worked out well. I did some research through the male clinic and they had housing recommendations but those I found didn’t take dogs or I would have used one of them. Of course I had time to do a lot of planning because it took me a long while to really commit and make the decision once they gave me their opinion. It differed from my doctors here in Texas and I was confused. I have a very good surgeon here in Texas as well as my infectious disease doctor but I was 42 at the time and they were worried about me losing my hip entirely because I’ve had so many surgeries on it in the past and I don’t have a whole lot of bone left. I’m happy to say that the infectious disease doctors and the surgeon at the Mayo are amazing. My level of care there was outstanding and I am hopeful this infection is gone. I am trying to make it a full year with my spacer to make sure before I try to do it all over again. I definitely feel that finding the right surgeon is the best. I’m not sure what type of infection you have or your timeframe on things but if I can help answer any questions on traveling for surgery I’m happy to help anyway I can. I was looking at the various Mayo Clinic locations and I went to Rochester because I had read an article of what they were working on for a non-surgical cure implant related infections and that was being done in Rochester. I had hoped that they were closer and perhaps I could wait a bit longer but it appears there a long way off. From what I am told of others who have been at the Mayo Clinic Rochester was an excellent choice for orthopedics and infectious disease.

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@crgentry

Hi! I’m new to this Mayo Clinic connect. I was searching for living with an antibiotic spacer and mobility expectations when I came across your original post back in November 2017. I’ve been looking at this thread and I see you’re quite far in your journey. I’m so sorry the infection appears to be back. I just had surgery in May at the Mayo Clinic in Rochester Minnesota. I’m from Texas. I lived with my staff infection for about 4 1/2 years on suppressive therapy (Bactrim 1 pill a day) when I saw a sought a second opinion from the infectious disease and orthopedic surgeon at the Mayo. I traveled with my mom and we took our two small dogs with us. We knew we would be there for at least the six weeks of IV antibiotic treatment after I got my spacer put in. I rented a small house through Home Away that worked out well. I did some research through the male clinic and they had housing recommendations but those I found didn’t take dogs or I would have used one of them. Of course I had time to do a lot of planning because it took me a long while to really commit and make the decision once they gave me their opinion. It differed from my doctors here in Texas and I was confused. I have a very good surgeon here in Texas as well as my infectious disease doctor but I was 42 at the time and they were worried about me losing my hip entirely because I’ve had so many surgeries on it in the past and I don’t have a whole lot of bone left. I’m happy to say that the infectious disease doctors and the surgeon at the Mayo are amazing. My level of care there was outstanding and I am hopeful this infection is gone. I am trying to make it a full year with my spacer to make sure before I try to do it all over again. I definitely feel that finding the right surgeon is the best. I’m not sure what type of infection you have or your timeframe on things but if I can help answer any questions on traveling for surgery I’m happy to help anyway I can. I was looking at the various Mayo Clinic locations and I went to Rochester because I had read an article of what they were working on for a non-surgical cure implant related infections and that was being done in Rochester. I had hoped that they were closer and perhaps I could wait a bit longer but it appears there a long way off. From what I am told of others who have been at the Mayo Clinic Rochester was an excellent choice for orthopedics and infectious disease.

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Sorry for the grammar errors. That’s me talking into my phone 🙂

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Sorry to hear of your health problems. I have had 5 knee surgeries on my left knee and (4 new knee joints ) one was an Antibiotic Spacer. I was told not to put any weight on the spacer which prevented me doing any exercise or walking. I used a Walker to lift myself off the floor as I moved my right leg into position. I have knee joint #4 in place now praying for a more successful outcome. But we'll see.

Liked by Candace

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@crgentry

Hi! I’m new to this Mayo Clinic connect. I was searching for living with an antibiotic spacer and mobility expectations when I came across your original post back in November 2017. I’ve been looking at this thread and I see you’re quite far in your journey. I’m so sorry the infection appears to be back. I just had surgery in May at the Mayo Clinic in Rochester Minnesota. I’m from Texas. I lived with my staff infection for about 4 1/2 years on suppressive therapy (Bactrim 1 pill a day) when I saw a sought a second opinion from the infectious disease and orthopedic surgeon at the Mayo. I traveled with my mom and we took our two small dogs with us. We knew we would be there for at least the six weeks of IV antibiotic treatment after I got my spacer put in. I rented a small house through Home Away that worked out well. I did some research through the male clinic and they had housing recommendations but those I found didn’t take dogs or I would have used one of them. Of course I had time to do a lot of planning because it took me a long while to really commit and make the decision once they gave me their opinion. It differed from my doctors here in Texas and I was confused. I have a very good surgeon here in Texas as well as my infectious disease doctor but I was 42 at the time and they were worried about me losing my hip entirely because I’ve had so many surgeries on it in the past and I don’t have a whole lot of bone left. I’m happy to say that the infectious disease doctors and the surgeon at the Mayo are amazing. My level of care there was outstanding and I am hopeful this infection is gone. I am trying to make it a full year with my spacer to make sure before I try to do it all over again. I definitely feel that finding the right surgeon is the best. I’m not sure what type of infection you have or your timeframe on things but if I can help answer any questions on traveling for surgery I’m happy to help anyway I can. I was looking at the various Mayo Clinic locations and I went to Rochester because I had read an article of what they were working on for a non-surgical cure implant related infections and that was being done in Rochester. I had hoped that they were closer and perhaps I could wait a bit longer but it appears there a long way off. From what I am told of others who have been at the Mayo Clinic Rochester was an excellent choice for orthopedics and infectious disease.

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Thank you Candace. Wow…a year w/ a spacer! I had mine for three months and was sooo glad to get it out…but my infection came back pretty quickly. Others on here who had experience with spacers recommened keeping it for as long as I could, so that's good advice. You've had the spacer for 4-5 months or so now…how well are you able to get around?

Fortunately my latest episode a few weeks ago turned out to be a false alarm (of sorts). I definitely had some kind of infection going on…swelling, redness and hot to the touch. It was on one side of my surical scar, but it was improving by the time I got in to see my infectious disease Doc. He thinks it might have been something superficial, and not originiating from the joint. He said "scars can do weird things sometimes". It scared the heck out of us, but he other times the joint infection presented, it also came with a loss of strength and flexibility. That didn't happen this time and I take a little comfort in that fact.

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@lturn9

Sorry to hear of your health problems. I have had 5 knee surgeries on my left knee and (4 new knee joints ) one was an Antibiotic Spacer. I was told not to put any weight on the spacer which prevented me doing any exercise or walking. I used a Walker to lift myself off the floor as I moved my right leg into position. I have knee joint #4 in place now praying for a more successful outcome. But we'll see.

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Praying #4 works well for you.

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