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

@crgentry

Praying #4 works well for you.

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Thank you for your prayers! I hope others will remember me in their prayers as well.

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@mrfish

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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Oh my! I'm so glad to hear that. What a scare it was I'm sure. I pay your new hip continues to do well for you and no infection or any other complications.

I think I'm doing reasonably well with the spacer. I was toe touch weight bearing with my walker/crutches for about 5 weeks. The surgeon saw me before I left to head back home and I was released to drive home, weight bearing as tolerated, side leg lifts (a thousand a day he said jokingly), swimming, and very light stationary bicycle. It took me another couple weeks to put more weight on it. He wanted me to wean to just one crutch by the end of July and I made it. I do my side leg lifts, stretch regularly (whole body but carefully with the leg) and I've done some swimming, I feel the best in the water. It's sore in the front thigh area but I'll take sore any day over how crappy I was feeling with the infection. Every now and then I get some sharp pains when I do certain movements but not often and I can't identify what I'm doing so I just deal with it. I'm guessing it's the spacer, doesn't last long and it's tolerable. I think I was almost to make it to a cane the end of August but I tripped over a floor mat leaving a restaurant and had quite the setback. I did the try to keep yourself from falling thing and it was definitely not ready to take that weight or pressure in the front. I think I strained my thigh mussels and just tweaked my knee and whole leg in general. Back on two crutches I went. My massage lady has helped tremendously and is experienced in medical massage and orthopedics. Most importantly does not cost a fortune as most medical massage therapists do. I saw my Ortho here a little earlier than planned to make sure I did't hurt the spacer but it looks good and I'm about to send off my CD to the surgeon at Mayo and ask a few questions. I'm just now starting back to where I was before the trip thankfully.

Without some PT and more strength training I don't see me getting off my one crutch until I get my new hip. Which is fine, this leg has been through a lot of surgeries so I'm happy to wait it out to make sure and give myself the best chance for success with the final hip. I've got 40 pounds to loose so that will give me some time to get more healthy now that I feel good again.

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@crgentry

Oh my! I'm so glad to hear that. What a scare it was I'm sure. I pay your new hip continues to do well for you and no infection or any other complications.

I think I'm doing reasonably well with the spacer. I was toe touch weight bearing with my walker/crutches for about 5 weeks. The surgeon saw me before I left to head back home and I was released to drive home, weight bearing as tolerated, side leg lifts (a thousand a day he said jokingly), swimming, and very light stationary bicycle. It took me another couple weeks to put more weight on it. He wanted me to wean to just one crutch by the end of July and I made it. I do my side leg lifts, stretch regularly (whole body but carefully with the leg) and I've done some swimming, I feel the best in the water. It's sore in the front thigh area but I'll take sore any day over how crappy I was feeling with the infection. Every now and then I get some sharp pains when I do certain movements but not often and I can't identify what I'm doing so I just deal with it. I'm guessing it's the spacer, doesn't last long and it's tolerable. I think I was almost to make it to a cane the end of August but I tripped over a floor mat leaving a restaurant and had quite the setback. I did the try to keep yourself from falling thing and it was definitely not ready to take that weight or pressure in the front. I think I strained my thigh mussels and just tweaked my knee and whole leg in general. Back on two crutches I went. My massage lady has helped tremendously and is experienced in medical massage and orthopedics. Most importantly does not cost a fortune as most medical massage therapists do. I saw my Ortho here a little earlier than planned to make sure I did't hurt the spacer but it looks good and I'm about to send off my CD to the surgeon at Mayo and ask a few questions. I'm just now starting back to where I was before the trip thankfully.

Without some PT and more strength training I don't see me getting off my one crutch until I get my new hip. Which is fine, this leg has been through a lot of surgeries so I'm happy to wait it out to make sure and give myself the best chance for success with the final hip. I've got 40 pounds to loose so that will give me some time to get more healthy now that I feel good again.

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Hello from the UK. I've just spent the afternoon reading this thread. I wish I had found it earlier. I too have had a staph infection in a hip that was less than a year old. The bug I had was staphylococcus Caprae. I had a debridement in November 2017 and 6 weeks of oral antibiotics. The infection returned New Years eve! I had my hip removed 5/6/18 and a spacer inserted. I was in hospital 2 1/2 weeks had Vancomycin and oral Rifampicin. I came home on once day IV Teicoplanin and the Rifampacin. In total 7 weeks of antibiotics. Tomorrow I get the second stage hip replacement. It has been encouraging, Mr Fish to hear of your relief after the THR as although I have pain I havn't needed strong painkillers just Paracetamol and Diclofenac. I've had the occasional Tramadol about 2 per month. The grinding and popping makes me feel nauseous! I shall be glad to be free of that. I walk with a frame or crutches and am aloud 50% weight bearing. I know nobody that has had this surgery so would be lovely to chat to you all. Lin

Liked by Candace

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I had total hip replacement July 2016. It started bothering me in April 2018. A knot came up & went down twice in April & May. The 2nd time it was golf ball sized & you could see it through my jeans. It busted & drained everyday for 13 days. I went to urgent care during that time & they did a culture, which came back & they tried 3 different antibiotics. I had my year check up with ortho & they did an aspiration & found pseudomonas infection. I had the hardware removed & an antibiotic spacer put in August 1st. I did 6 wks of IV antibiotics (3 times/day). They took my pics line out & I went 2 & 1/2 wks with no antibiotics. Another aspiration was done. I got the results Wednesday & nothing grew in the culture. But, my ortho dr is not able to schedule surgery until the week before Christmas!! And the Dr I saw (my regular ortho dr was in surgery) said they may or may not put a new hip in on that date. If it looks good they will, but if they don't like what they see, they'll take this spacer out & put another in. And there's a chance (a pretty good 1 according to him), that I'll be on oral antibiotics the rest of my life!! I'm only 42 yrs old & I kinda plan on living quite a while longer. I've been walking with no crutches or anything for 2 wks, even went to Dr appt without crutches. They said it was probably OK since I only weigh about 115lbs. Is it REALLY ok to go for prolonged periods walking with no help??

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@linjane

Hello from the UK. I've just spent the afternoon reading this thread. I wish I had found it earlier. I too have had a staph infection in a hip that was less than a year old. The bug I had was staphylococcus Caprae. I had a debridement in November 2017 and 6 weeks of oral antibiotics. The infection returned New Years eve! I had my hip removed 5/6/18 and a spacer inserted. I was in hospital 2 1/2 weeks had Vancomycin and oral Rifampicin. I came home on once day IV Teicoplanin and the Rifampacin. In total 7 weeks of antibiotics. Tomorrow I get the second stage hip replacement. It has been encouraging, Mr Fish to hear of your relief after the THR as although I have pain I havn't needed strong painkillers just Paracetamol and Diclofenac. I've had the occasional Tramadol about 2 per month. The grinding and popping makes me feel nauseous! I shall be glad to be free of that. I walk with a frame or crutches and am aloud 50% weight bearing. I know nobody that has had this surgery so would be lovely to chat to you all. Lin

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Hello @linjane and @juskunfuzed. Welcome to Mayo Clinic Connect!

Jane, best of luck with your surgery tomorrow- please stop back and keep us updated on your progress.
@juskunfuzed– call every day to see if an earlier surgery has opened up. People cancel appointments all the time. Also, please call and talk with your primary about using your crutches and walking with no help. I agree with you- 42 is young to be taking a daily antibiotic for the rest of your life. Get another opinion and let me know what you decide. I'm interested to see what your doctor says.

Liked by lioness

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@jamienolson

Hello @linjane and @juskunfuzed. Welcome to Mayo Clinic Connect!

Jane, best of luck with your surgery tomorrow- please stop back and keep us updated on your progress.
@juskunfuzed– call every day to see if an earlier surgery has opened up. People cancel appointments all the time. Also, please call and talk with your primary about using your crutches and walking with no help. I agree with you- 42 is young to be taking a daily antibiotic for the rest of your life. Get another opinion and let me know what you decide. I'm interested to see what your doctor says.

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Hi everyone I'm on the other side. Its wonderful. The op wasn't straight forward as they had to break my trochanter last time to get the hardware out. This hadn't healed so they have put a plate in. This means I've got to be only 50%weight bearing for next 6 weeks. Just got out of bed and walked. It was the easiest walk I've done in 18 weeks. So hopefully juskunfused it will be the same for you. Awaiting results on all the swabs but I'm back on the Vancomycin again until their back. Looks like this will be what keeps me in hospital. Fingers crossed the swabs will be negative.
Juskunfuzed, I too had the abscesses you describe but mine stayed contained prior to diagnosis. I've had to wait 12 weeks following the completion of my antibiotics (should have been 6 weeks) and what I've read research shows the longer you wait the better the outcome. Christmas isn't so far away but I agree it feels like it with that wretched spacer in! The end is in sight and I wish you well. Will update in a few days.
Lin

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@jamienolson

Hello @linjane and @juskunfuzed. Welcome to Mayo Clinic Connect!

Jane, best of luck with your surgery tomorrow- please stop back and keep us updated on your progress.
@juskunfuzed– call every day to see if an earlier surgery has opened up. People cancel appointments all the time. Also, please call and talk with your primary about using your crutches and walking with no help. I agree with you- 42 is young to be taking a daily antibiotic for the rest of your life. Get another opinion and let me know what you decide. I'm interested to see what your doctor says.

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Sorry I've been off here for so long!! I'm still waiting, but I've been filling in at work for about 3 wks now. It's only about 4-5 hrs/day so that's not too bad. None of the drs around will even see me because I'm already half-way thru the procedure. Nobody wants to step on another Dr's toes, I guess. I did my PT exercises at home last night. That was the 1st time I've done them in a while because I forget. But today, my leg is hurting!! I'm not sure if it's the exercises, the rain & 40° temps outside, or maybe I've done something to it. I have to think it's a combo of the exercises & the drop in temps, or at least I sure hope so!!

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Hi my husband had right hip replaced in March 2014 and left hip replaced on January 2015 and rods with screws in his back. He was doing very good. Everybody said they could not even tell he had his hips replaced. In August of this year he said he had some pain in his left hip, he was due for a follow up here in December anyway. I called ortho and made an appointment. They took a xray and wanted to do a hip asparation and put a steroid in the tenion to see if that would help. We went back a week later for the test results and his levels were so high to which the Dr new he had a infection and said he wanted to do surgery the next day. So Oct 26th he had the replacement hip removed and a spacer put in. He is now non weight bearing on left leg for 3 months and iv antibiotics (Vancomycin ) for 6 wks then the new is to be put back in. But how do they know if the infection is gone? And I'm worried because the Dr said no weight at all on left leg and he lost his balance and stepped down on his left foot twice this morning, will this create a problem with the spacer?

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@jimandlisa

Hi my husband had right hip replaced in March 2014 and left hip replaced on January 2015 and rods with screws in his back. He was doing very good. Everybody said they could not even tell he had his hips replaced. In August of this year he said he had some pain in his left hip, he was due for a follow up here in December anyway. I called ortho and made an appointment. They took a xray and wanted to do a hip asparation and put a steroid in the tenion to see if that would help. We went back a week later for the test results and his levels were so high to which the Dr new he had a infection and said he wanted to do surgery the next day. So Oct 26th he had the replacement hip removed and a spacer put in. He is now non weight bearing on left leg for 3 months and iv antibiotics (Vancomycin ) for 6 wks then the new is to be put back in. But how do they know if the infection is gone? And I'm worried because the Dr said no weight at all on left leg and he lost his balance and stepped down on his left foot twice this morning, will this create a problem with the spacer?

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@jimandlisa Ive never had hip surgery but being a retired O.R. nurse if the Dr told him no weight bearing on L.hip he needs to adhere to that the outside looks good but it takes along time for the muscles,nerves bone to heal so please listen to Dr.,does he use crutches ,cane or walker ?this will help him get around without putting weight on that hip.

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They will take another sample of the fluid around his hip and test it. It usually takes 1-3 weeks to see if the fluid has any infection in it. Tell the Doc he put weight on the spacer – I had one in my knee and was told No weight on it. I was basically bed ridden for 8 weeks. Not fun at all! I will keep you and your husband in my prayers. Best wishes.

Liked by lioness

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@juskunfuzed

Sorry I've been off here for so long!! I'm still waiting, but I've been filling in at work for about 3 wks now. It's only about 4-5 hrs/day so that's not too bad. None of the drs around will even see me because I'm already half-way thru the procedure. Nobody wants to step on another Dr's toes, I guess. I did my PT exercises at home last night. That was the 1st time I've done them in a while because I forget. But today, my leg is hurting!! I'm not sure if it's the exercises, the rain & 40° temps outside, or maybe I've done something to it. I have to think it's a combo of the exercises & the drop in temps, or at least I sure hope so!!

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Hi Jamie my spacer very temperamental. My guess is you have tweaked it and it dosnt like it. Mine would settle. When I was on the other side of the second stage I told all the staff to never underestimate the pain involved with a spacer. It really is a joy to walk again even though I can only 50% weight bear until December. Will update in later post. Good luck and be patient I know it's hard as I know where you are coming from but it should be worth it.
Lin

Liked by lioness, Candace

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@jimandlisa

Hi my husband had right hip replaced in March 2014 and left hip replaced on January 2015 and rods with screws in his back. He was doing very good. Everybody said they could not even tell he had his hips replaced. In August of this year he said he had some pain in his left hip, he was due for a follow up here in December anyway. I called ortho and made an appointment. They took a xray and wanted to do a hip asparation and put a steroid in the tenion to see if that would help. We went back a week later for the test results and his levels were so high to which the Dr new he had a infection and said he wanted to do surgery the next day. So Oct 26th he had the replacement hip removed and a spacer put in. He is now non weight bearing on left leg for 3 months and iv antibiotics (Vancomycin ) for 6 wks then the new is to be put back in. But how do they know if the infection is gone? And I'm worried because the Dr said no weight at all on left leg and he lost his balance and stepped down on his left foot twice this morning, will this create a problem with the spacer?

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Hi Lisa. You have my sympathy I know where you are coming from it is a constant worry that the infection may come back. I've had the second stage 3 weeks ago and am doing well but there is a constant fear in the back of my mind. It's a case of taking it day by day and I have to say my new hip feels completely different this time so I feel reassured by this, as I always had pain and stiffness before. He must listen to his surgeon and if he says non weight bear that's what he has to do. I was lucky I had 50%. Although I did fall 2 weeks after the first stage onto my driveway. I saw my surgeon the next day as had an appt anyway. Everything was fine id done no damage. I was lucky. I wish Jim well. Vancomycin is a very powerful drug I had it with first and second stage so you must put your faith it that.
Lin

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My latest update. I got out of hospital after 8 days. I'm moving really well and am only on Diclofenac and Paracetamol for pain now. My leg stiffens a lot but I can't really say it's pain. Although getting a lot of swelling. My swabs taken my surgery for the original staph infection showed the bug had gone. Unfortunately the enriched growth at 7 days showed the presence of Staphlococcus Haemolyticus! However it seems my microbiologist is confident it is a contaminant. I'm hoping and praying he is correct. Since those swabs I've had 8 days of IV Vancomycin and now have 6 weeks of Ciprofloxacin 500mg BD and Rifamicin 300mg BD to complete. I have to be positive this hip is so much more comfortable. The last one hurt and was tight and stiff from day one. I wish you all well. Will update when I have more news. Supposed to see my surgeon this week for follow up but have been told he has no appts until after Christmas!!!!! I feel he will see me soon as he is a good man.

Liked by mrfish, Candace

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@linjane

My latest update. I got out of hospital after 8 days. I'm moving really well and am only on Diclofenac and Paracetamol for pain now. My leg stiffens a lot but I can't really say it's pain. Although getting a lot of swelling. My swabs taken my surgery for the original staph infection showed the bug had gone. Unfortunately the enriched growth at 7 days showed the presence of Staphlococcus Haemolyticus! However it seems my microbiologist is confident it is a contaminant. I'm hoping and praying he is correct. Since those swabs I've had 8 days of IV Vancomycin and now have 6 weeks of Ciprofloxacin 500mg BD and Rifamicin 300mg BD to complete. I have to be positive this hip is so much more comfortable. The last one hurt and was tight and stiff from day one. I wish you all well. Will update when I have more news. Supposed to see my surgeon this week for follow up but have been told he has no appts until after Christmas!!!!! I feel he will see me soon as he is a good man.

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I'm so glad you're on the other side of it! I had a terrible time with my spacer and was so glad to be done with it. Cultures do get contaminated sometimes, and I'm crossing my fingers for that to be the case with yours. You'll have your mobility back in no time, now get at it with the PT! 🙂

Liked by Candace, linjane

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@jimandlisa

Hi my husband had right hip replaced in March 2014 and left hip replaced on January 2015 and rods with screws in his back. He was doing very good. Everybody said they could not even tell he had his hips replaced. In August of this year he said he had some pain in his left hip, he was due for a follow up here in December anyway. I called ortho and made an appointment. They took a xray and wanted to do a hip asparation and put a steroid in the tenion to see if that would help. We went back a week later for the test results and his levels were so high to which the Dr new he had a infection and said he wanted to do surgery the next day. So Oct 26th he had the replacement hip removed and a spacer put in. He is now non weight bearing on left leg for 3 months and iv antibiotics (Vancomycin ) for 6 wks then the new is to be put back in. But how do they know if the infection is gone? And I'm worried because the Dr said no weight at all on left leg and he lost his balance and stepped down on his left foot twice this morning, will this create a problem with the spacer?

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Wow, over three years and then an infection? I'm sorry to hear that, it must have been quite a shock. With my spacer they said I could be 50% weight bearing, and I doubt I could have really put 50% weight on it anyway…the pain was too great. Did they give your husband a reason for no weight bearing at all?

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