I like that you are sitting instead of standing, you guys stand on your feet in the o.r. all day. Glad to see your taking care of your joints. Thanks for all your advise.
Little purple bacteria guy was a great addition to your video. Although I take my antibiotics religiously before visiting the dentist, this is my greatest fear for 2 to 3 weeks after I see the dentist. Stay safe.
Wish I had a good story, but I'm laying in a hospital bed right now and I've been here for two weeks because of an infection of my recent total knee replacement that was done on January 25, 2024. I was told by the infectious disease doctor that came to see me that I would be on antibiotics for life. However, my surgeon said more like six months to a year. I then went back to the infectious disease doctor who hedged her bet a little bit and said well maybe six months to a year But she didn't sound confident I was actually doing great after the initial surgery to replace my knee and didn't need my walker or a cane after one day I was able to do all my exercises and rehab the knee at home. Then 10 days ago out of nowhere I couldn't walk on the leg. It slowly started to swell and I got a fever and I had my son drive me to the emergency room where they transferred me to the original hospital where I had the surgery done so that the original surgeon could do the revision. I've been here ever since. I have to say that if I had to do it all over again, I would never do it. That makes me pretty sad because I was planning on doing my other leg as soon as the first one was rehabbed. Anyway, sorry to be a downer and thanks for the video
Really Thanks for the Video, my Implant was affected with Prosthetic Joint Infection due to Loosening of the Implant which was not cemented at the time of Surgery a year ago. Later, after serious decisions with Senior and experienced Doctors, I went for Amputation my Leg 🦵 above Knee. I felt it was the correct surgery 😊 to be done on me undertaking my post 4 surgeries within 4 years.
Hi, how are you know? Don't mean to be nosy, its just that mom had knee replacement in late June and currently is in the same stage now as you where when you posted this. Was hoping you can tell me a bit more about your process?
@@sharoonjoseph3639hey, can I ask why you never went for the antibiotic spacer? Or was it not an option for you? I had my replacement in February this year, ended up with an infection two weeks later. I have had three washouts since then and now have another infection and considering the spacer and new replacement. I am only 35 so considering this before I go for the chop like yourself! Hope you are doing ok! Sending my love xx
Fortunately I've never had knee problems, but my Dad had both done 5 & 6 years ago at UBC hospital here in Vancouver, thankfully both with great success. However, I do have a friend south of the border who has had painful ongoing issues with his knee joint replacement. I have shared your previous videos on this subject in hopes of providing some valuable information for him.
I had MRSA infection in an eight year old hip replacement in March. I was in severe pain for about a week before surgery was done and it was cleaned out and plastic was replaced. I was on antibiotics via pic line in a rehab facility then at home for 7 more weeks until the CRP finally went t normal. Both my infectious disease dr and orthopedic surgeon who is a trauma surgeon say antibiotics for life. I’m on doxycycline 2x day. I pray I never go thru that again.
Thanks Docs, 56 year old cop from Tasmania, Australia. TKR on 15th Feb 2024, infection symptoms hit about week 7, Aggressive debridement 24th May 2024. PICC line inserted for 6 weeks IV antibiotics and 1 week since and I fear the swelling , heat and tightness means it didn’t work. Medical team are great. But it’s been a tough road so far. Your videos are so great. Hope my markers for infection come down, results should be in soon.
I'm so sorry! Hope U R better now. I possibly will have a TKR in a few mos. I've had sepsis MRSA in the past and was hospitalized for 6 wks., PICC line and everything like you, so I know how U feel. Hope I'll do fine. God Bless! I'm from the states.
Great video as usual! I had an infection in my prosthetic hip two years later. Another surgery, debridement etc. Followed by IV and oral antibiotics for 12 weeks. Doing fine now.
TKR 3/12 did well 5 weeks after developed chills headache fever really awful feeling temperature 101.9 it all happened at once Went to ER treated me with antibiotics but ran all kind of testing for blood clots since leg was red and after 4 days went home on antibiotics dg cellulitis superficial and thank God resolved 🙏🏾🙏🏾
I’m so glad I looked up your videos. I literally watched the one from 7 years ago and then found this one!!! I had THR on 12/21, yesterday I felt a wetness coming from my bandage took it off and my wound is leaking pus. My husband took pictures and I called my orthopedist today, I emailed them pictures and they prescribed antibiotics within minutes of the email and want to see me tomorrow. I’m definitely nervous about my visit but praying that the joint isn’t infected.
I’ve had 4 hip replacements, 2 on each hip. The last one was on sept 20. I had hip failure but had to wait over a year for surgery due to Alberta Canada’s terrible health care. I’m 69 years old. It was a rough surgery, my knee was damaged during surgery, surgeon who has no compassion said “sometimes things can get a little rough during surgery as we use your knee as an anchor, we may have damaged it”. It’s still swollen and painful. They did the debraidment found metalolsis non malignant cysts which they removed. My chromium/cobalt range were over 100. I also had a ham string tear and tendon rupture due to my long wait for surgery. Recovery has been slow this time, still using a cane and doing physio. My hip is still swollen but no pain. In addition 5 screws were added. I can feel them it’s a strange feeling. Also my leg is now longer. I’m a strong lady but I must say I’ve had enough of this. Thanks for all you do. I love your entertaining and informative vids. Learned a lot about many things. Happy New Year.
@@barbaraebner5889 no there is a long wait list for all surgery’s. There are private clinics in Edmonton and Calgary if you have thousands of dollars to pay for surgery.
Same my hip is infected and my surgeon after 2 botched surgeries hands me off to a stranger, now because of the long wait and opioids they are gonna take my nursing licence away, and it made me so constipated that it hurts a hole through my intestines to my bladder so I’m peeing feces. Now I probably will have a colostomy bag and maybe a wheelchair after 3 major surgeries. I’m only 43 and I have not walked in years. I have a broken pelvis and nobody is doing anything. The second new surgeon in Toronto has not called me back. My liver enzymes are through the roof my platelets are down and my blood is like tomato juice. I’m probably dying. This was all caused by the security guard at the local hospital body slammed me on the cement on my hip with AVN. I reported it 2 years ago and nobody did anything. They will get away with all of this. I’m fighting on my own and my abusive mother who is 75 pushed me down on my hip and laughed. She broke her hand punching and now she has a cast. She was yelling get up you beep get up!!! She wanted me on my feet and she tried calling only the police but I screamed for the ambulance, they came and they didn’t charge her. If that was me I’d be in jail. She had done nothing for me my whole life and I have nobody. My family walked away from me after I took care of my dad for what !? So I could be homeless with no job and disabled. Oh well anyways that’s it.
I am over 7 years since my total knee replacement I deal with severe at times pain every day and I am on some potent medication I have been checked for infection and other things, my first surgery was in 1978 I had a knuckle of bone broke in my knee and it was pinned back with Smiley pins and I guess the wear and tear through life resulted in needing the TKR right now I am waiting to go see another surgeon for a second opinion on having an above knee amputation to try and get some quality of life, I am only 60 years old and not ready to sit in the rocker and go off my rocker quite yet. Here in NL we have some good doctors I hope I get one that will help me out. I really enjoy the content that you guys put out you give the information in a way that is easy to understand. Thanks for all you do.
Thank you?? for the info, I have been following you guys for 3 years, and you have provided me with a great deal of knowledge, but can we just go back to discussing the excruciating discomfort and pain of post-surgery and physio, never thought I would miss those days, and now they seem like the good old days. My surgery is on Jan 19th, 2024, and I really want to thank you for what you're doing, I have come to rely on your information, and it really is greatly appreciated. Oh, and my wife who is a retired ICU and Nursing educator with a specialty in evidence-based practice says you're kinda ok too.
Very much appreciate the real scope of this. Clear description of the full range of treatments and possible, real-world outcomes. Also noted that you were more subdued in the typical humorous playfulnesses. Very appropriate.
I need a knee replacement, have an appointment in a couple days for a consult & now very concerned after seeing this video. I've read that infections are rare but it still doesn't give that warm & fuzzy feeling inside, especially after reading all the comments below, quite a few to be honest. Thanks for your videos, you both are so informative, many thanks.
Having had a total knee replacement 2 years ago and a total hip 2 months ago,this is a bit scary. I'm looking at my other hip replacement soon, and my other knee hopefully a few more years out. I hope I don't get it! So sorry for those that do. Wish you all the best!
Worked in PACU 30+ years, and it's so interesting to really get into the nitty-gritty of WHY these different procedures were done after the total joint became infected
Exactly I think I only had 3 rounds of antibiotics for my revision and protocol is 5. Also glued together twice that lead to poor healing and big Keiloid scar. I’m terrified I’m gonna die
I am going through this agony now on year #3 on a total knee replacement. Elevated CRP and ESR test results. Are there any videos of patients who have SUCCESSFULLY gone through a single or 2 stage surgery? Thank you so much for your excellent insights!
So we don't have any videos about patient cases but we have lots of patients who have gone on to cure their infections. Sorry to hear you are having such a tough go
I care for an 84yr old lady.. she is post knee revision x4 years but for last 2years has been on oral antibiotics. Now a red boil like wound has come up 3times in 3 months. ? Sinus tract infection. Do not know what might be best action. CRP and other labs normal. She had first revision due to this same infection process
Patients with " leaky gut". I think it's fair for surgeons to send patients to a internal medicine specialist first, so they can treat greatest route of bacterial infection. I really enjoy these educational videos. Keep up your good work.
I am scheduled for a revision surgery on my right total knee replacement on Nov. 27, 2024. I had a UTI that became septic and I was temporarily in renal failure. I also had a painful, swollen right knee. My kidney function has greatly improved but I had aspiration of my synovial fluid from my knee. The culture was e. coli and enterococcus faecalis. My original knee replacement was in 2012.
Thanks for answering this important question! But what do you tell your replacement patients about avoiding these infections in the first place? Do you recommend patients take antibiotics in conjunction with dental procedures, specifically cleanings? Is there a difference between ortho surgeons and the dental association in Canada? Apparently there is a differential here in the states...our surgeon told us we didn't want to be the few who have to have a revision based on an infection? How about simply cutting yourself? I use Betadine to clean any of those injuries to minimize the chance. Not trying to overthink this but could be important to all of us with replacements. Thanks guys!
I know someone that had a bone infection following a broken ankle and they went through all the sequence of trying different things and eventually ending with amputation. He was actually upbeat and relieved after the amputation because he could be done with the whole saga. So far, he seems to be doing well with his new prosthetic
When I was in hospital last 2022 the person in the bed next had an industrial accident and had to have his foot amputated. His new prometheus foot which was GPS controlled cost £65,000. I was told it changed it's own action depending if you were walking up or down hill. He was looking at million GBP compensation coming.
Thank you Dr Obaz, You’re such a wonderful doctor and you always make me feel so safe. The compassion with which you treat the patients is more effective than any medicine! God bless you doctor 💢
wonderful video with some great information. It seems even with the best possible outcome it's still a lot of work for the surgeon and a lot of time for treatment for the patient---antibiotics time included. I can't begin to imagine how hard it must be to completely replace a replacement, given they are put in to be permanent. And the amputation option---that one is so tough. But it sure bets dying from a very bad infection.
Love your informative channel! I’m a retired OR nurse. What about a terminally infected shoulder joint? Would you remove hardware and cement the joint like the hip (since amputation isn’t an option like a knee)?
Do you have some adhesive capsulitis? I had a shoulder fracture/dislocation with ORIF. Kept having pain. Original doc just told me to keep exercising. Went for a second opinion. New Doc recommended an arthroscopy. Found severe adhesive capsulitis. And he also found I had sustained injury to my biceps tendon in the original injury so he did a biceps tenodesis. I woke up from surgery with minimal pain and went on to complete PT and have not had any issues since.
My sister had her second knee replaced over 2 years ago. She got an infection in that knee and unfortunately acquired sepsis for this. Then after they replaced the parts she came down with c-difícil. Such a horrible thing to go through. She is now on antibiotics for the rest of her life!
This is such an informative and excellent video. I’m very impressed with how much you were able to explain on the treatment of infected joint replacements from the ’mild’ to the ‘extreme’ in a short time. You gave percentage recovery details but gave little idea as to the frequency of serious infections. Have either of you had to remove the hardware in either hip or knee replacements? Towards the end the most serious outcome for the patient is amputation. However, this was followed by explaining that life-long antibiotic treatment,which carries risks, would enable the patient to keep the limb. However, surely life-long antibiotic treatment is preferable to losing a limb? I may be totally wrong! Question - Does the cement used when an implant is first inserted contain an antibiotic similar to the cement used second time round? Many thanks Docs for a really fascinating insight into the treatment of infection which may occur after a knee or hip replacement
HELP ! My mom went through a hip replacement no one not two not three but 5 times. The first four times no infection at all. Luxation was the problem. In fact last time they removed the whole thing. Last surgery was on 12/12/23.: Infection after two courses of antibiotics. It was clear to me that it was most likely because there was a super hole between the staples. The rest of the wound healed famously. But now there is almost a balloon. The fistula is a balloon. My mom is 82, diabetic, and hasn’t done a proper rehab. After watching your video (Thank you) gave me clarity but also anxiety. I don’t think she is strong enough to overcome another “cleaning surgery”.
Had a reverse replacement shoulder procedure 2 1/2 years ago and got a severe abscess in March. Out with the prosthetic, in with a cement spacer and on with 6 weeks of intravenous antibiotics. Six months later the spacer came out and I have a new reverse replacement prosthetic. Third surgery was easier to recover from and I have 90% of my mobility back. Worst part is sleeping upright for 6 weeks after surgery but we rented a hospital bed with a good mattress which made it bearable. I really appreciate you guys. I now need a knee replacement but I have heard some doctors are reluctant to install a new knee after this type of infection. What do you think?
Hi Guys, Love your videos and watched a ton of them prior to my TKR in Jan 2023. Rehab was going well however I unfortunately slipped off a step & tore my quad tendon, about 3cm, same knee at Easter. Repaired in May and seemed okay for a couple of months but seemed to loosen. Dr scheduled repair for Oct but got an infection late Sept. I am in the middle of the 2 stage replacement after the 6 week IV. New replacement due Feb 5. Sometimes you are just the 1 to get Sh't luck. I am more than optimistic as the ortho & infectious disease team here has been FAB
24 years old here, was in a really bad car accident back in 2015. Had my pelvis reconstructed, 2 hip scopes, had my first replacement in 2020 the a revision last year in January 2023. During the revision my surgeon found bacteria and turns out it was infected. I then had a midline put in for a month and everything was good. Fast forward to 5 months ago I start getting terrible pain. Go back to the doctor, do all the tests, injections, you name it. Come to find out my total nucleated cells are at 4400. Going to see a different doctor in a few days to go over the 2 step surgery .
I had surgery on my right shoulder rotator cuff complete tear 5 anchors were put in. One week later, my incision broke open and started draining. My orthopedic surgeon took me back to the operating room did a washout with a drain in my shoulder 2 weeks after that first washout, Back in the hospital for second washout with another drain. Then six weeks of IV anabiotic’s every day. then three months of oral antibiotics. Amoxicillin twice a day. That was 2 years ago. today I am completely fine. Shoulder is fine. success. The infection was P. acne. Bacteria. The infectious disease doctors took over after my washouts they were excellent. I had to go to emergency room for IV anabiotic‘s every morning at 8 AM for six weeks. The oral’s were just amoxicillin 500 mg twice a day for three months. Now I am back in the gym lifting weights, I’m 100%. So glad that I had the surgery even with the infection. All the doctors took very good care of me.
I have a close friend who had this happen. He nearly died, so this is a very serious topic. For me, the question is: What if your implants were only put in to stabilize things while a bone fracture heals, or with something like scoliosis surgery? If there is an infection then, is it possible to simply remove the hardware? Thanks!
I'm on the waiting list for a total knee replacement. This is scary stuff especially as my husband has been told he could need a partial amputation due to a chronic ulcerated foot which isn't healing. The idea that god forbid we could if unlucky both end up with amputations is horrendous
Greetings Dr. Zal Zal and Dr.Weening. Many thanks for this video. I have a few people I know who are having hip or knee surgery, will advise them of this video. I had staph infection when I had spinal surgery in 1995. Thanks for all your hard work. Dr Zal Zal and Dr. Weening are great doctors.😊
I think it would be interesting to talk about scar tissue and the removal with manipulation under full anesthetic, although this isn't an infection. I believe if it occurs it is usually around the 9-12 weeks after the operation. Mine started after 3 weeks and being a personal trainer I was able to realize that something with my progress (mobility) was not quite right.
Unfortunately, this happened to my sister. She had knee replacement and not long after the pain worsened. She returned to her doctor and was told that the pain would go away, she just needed to keep exercising… then gave her pain pills. Six years later, due to long term infection in the bone above and below her knee, her leg had to be amputated. I saw her struggle with both pain and pain pill addiction. I’m scheduled for replacement the end of February, and greatly fear this happening to me.
Have you ever considered Red Light Therapy before and after the TKA. I have had both knees replaced now. Left one without red Light therapy. Right one with red light therapy. The rate of healing of the right knee is far greater than the left knee. The scar on my right knee is minute less than paper thin. Where my left knee has a normal scar as seen on my father and other people. Both wounds looked the same 12 days after surgery when the staples were removed. At 14 days after the operation on the right knee I had an urgent phone call from New Hall Hospital asking me how my wound was. I replied "fine" what your problem. New Hall hospital replied something went wrong with the operating environment. Everyone operated on that morning have infections in their wound. My wound was almost totally healed except for 15 mm at the top which was weepy. Which soon disappeared, I was still using red light therapy. If I was allowed to I could send you a photo of both knees together and the scar on the right knee is hardly visible.
Hello! Thank you for these videos that have helped me & my family understand my situation. After 7 years my TRKR became infected. Surgery phase 1 took place 9/25/24. I gave completed 6 weeks of antibiotics and am now on a 6 week antibiotic holiday before I see my surgeon again. Pain & swelling is starting to return and feels somewhat like it did when the infection first occurred. However, I have also recently switched from at home PT to outpatient PT. Should I be concerned? Is there a way to know if this is just from PT or if the infection is returning?
My Dad had a total hip replacement done in Jan. He has been struggling with it ever since and now it is infected. Seems like the infection has been there a long time already. He is scheduled for a step one of a 2 stage revision July 12. They are using an articulated spacer. I'm wondering what his expected level of function will be after the 1st stage while the articulated spacer is in place? Will he be able to walk, will he be very uncomfortable, etc? And advice is much appreciated! You alls videos have already been very helpful understanding the process!
Had left hip replaced in Nov 2023. Severe infection set in immediately after surgery. Pathogen was not identified. Went thru 3 additional surgeries surgeries to clean out infection and remove hardware and replace with antibiotic spacer. Infection spread to size of man's hand on front of hip. Weakness and tremendous pain. Patient was moved to Northwestern in Chicago for a month. Then one month of rehab at Shirley Ryan in Chicago. 10 months after surgery pain persists and patient can only walk for short distances before needing the aid of a walker. Real bummer ... hip replacement is NOT 'a piece of cake.' Surgeon informs that BEFORE second stage of revision, patient needs right hip replaced. Patient is skeptical of that order.
I am going through revision surgery due to infection from tkr. My surgeon put a spacer in with the second tkr. Infection is reducing. He has ordered a nickel piece which will be surgically inserted after 6 weeks of antibiotics and 3 weeks of antibiotics to ensure the infection is gone. Bit of a nightmare.
I had a deep tissue knee infection 7 years after a total knee replacement. It was supposed to be a 2 part revision. I had the first part of the revision in May 2023. I had an antibiotic spacer and a plastic piece bolted in place while I was given 2 IV antibiotics…one was vancomycin for 6 weeks. The vancomycin caused a kidney injury with my GFR dropping to 11 and my creatinine was 4.40. The infectious disease doctor kept my labs secretive for 3 weeks, by the time I was able to see a nephrologist the injury was not reversible and now 17 months later my GFR baseline is 22. Waiting until it drops to 20 for a kidney transplant. I have not completed the 2nd part of the revision because I will need antibiotics again and with the low GFR it isn’t advisable. They have never identified the bacteria that was in my knee. Please ask a lot of questions.
Hi! Question for the doctors.. I had partial knee replacement surgery two years ago and my surgeon suggests antibiotics before each teeth cleaning. FOR THE REST OF MY LIFE. I took them today as a matter of fact and my dentist told me just a couple hours ago that they are not needed beyond year two. Who is right?
@@DanAshleyChicago just asked my friend - he's a dentist and had hip replacement and he is also a bit confused but will likely take antibiotics also rest of life. infection vrs side effects of antibiotics ? no brainer
Hello, I had a total knee replacement in 21 for two years. I went with the Pain unbearable kept telling the doctor something was wrong. Doctor just kept saying keep up your exercise and therapy. Took bloodwork to make sure no infection said nothing showed up after two years, he just finally said there’s nothing else he could do so he released me. I went for a second opinion this doc said, the femur was loose so he goes in Cements the femur to the hardware and makes sure everything else is tight after the surgery. I got a call six days later that I have a bacteria infection in the knee part which he did not replace he never replaced any of it he only cemented the femur to the part. Long story short I was on antibiotics for a year and now all they’re doing is checking my blood work for infection, which the infection did not show up in the blood work from the get-go and the second doctor even told me that the part had to be infected when they put it in with my first surgery how can I trust that the infection is gone since I’m still having so much pain, swelling and inflammation in my knee and CRPS
Hi doc’s. Wish I did this a year ago. M - 61 . First TKR get home from hospital no one told me how to prep my house in some items I would need. I’m going to PT on my schedule pushing it. No I gotta get extension inflection about a month into it. I’m just having ridiculous pain and it was warm to the touch and my PT guy basically called me, a wimp like I wasn’t doing the exercises. Kept going kept pushing had to talk to the doctor. Something wasn’t right took over two weeks for me to see him. You could just look at it and tell it was infected so he decides we’re gonna do that washout and try some new spacers get me on IV and some. A month or so after his second surgery the spacers collapsed on top of each other basically locked my leg up off the floor about 4 inches. The infection turn to Mersa it was so bad at the time couldn’t do surgery till I can get my numbers down had to live with it that day after day, worst pain ever. He took one x-ray and decided to send me to the revision specialist in Gainesville about 45 minutes away. Great doc. He thinks he can fix it in doing another wash get everything out. I probably got Mersa. When I came out of surgery and came to, and I saw my doctor he said they did the best that I could do with what was there didn’t know what the hell that meant to find out you drove the titanium rod into my FEMA, threw a piece of antibiotic cement down into my tibia, another six months or so on antibiotics IV and oral, about 5 to 6 months and I went back to him for a check up. He told me that the knee has been through in 18 months of trauma. It’s gonna take at least a year it now 2 1/2 years later, but still can’t walk 10 feet, pain is still constant it looks mutilated like I was in a bad accident still swollen. so last month, I had to go back to the Infectious disease doctor get him to sign off , a cardiologist stress test in a couple of hours to sign off so now I’m just waiting for them to call me and tell me what day for my operation. I’m sick to my stomach. I think of the possibility of getting another infection, back on the pick line I guess. Up to me I would just run into antibiotics JIC . I trust this doc in Gainesville. if anybody can make it work, it’s gotta be him. he the one who built it. I honestly believe that if my PT believe me about something being wrong and the pain after the first month and I didn’t have to wait another two weeks to see this doc and they just sent me up to the revision specialist. I would probably be golfing right now. You guys are great love watching your videos on hypochondriac so that kind of stuff I need to check in with you guys lol have a great day. I’ll let you know what happens.
C reactive protein showed high infection but has lower down a lot. We are trying to nurture her as best as we can. What lab analyses does she need to identify the bacteria? It is going to be 4 MONTHS!! This next 4/12/24. Thank you for your help.
My mom has had surgery to clean up the hip infection. She's now on antibiotics intravenously for 6 wks then 6 weeksof oral. She's got a wound vac on it too. She wants to know how long she will have the wound vac on her hip? And how long she will be in rehab. Can you provide a general explanation of how much time this will take?
I am 2 yrs S?P) left TKA I was just diagnosed with a staph + infections. I am scheduled for surgery on 10/3/2024 to remove the old hardware and replace it, then a PICC line inserted for IV antibiotics. I am really scared right now. I worked so hard fo rmy rabge of motion and I'm afarain I won;t get as good results this time.
I wonder if this applies to having an ACL Allograft? I am 6 weeks post op and STILL battling an infection! The swelling is stopping my rehab, and I am frustrated with the surgeons lack of concern. Now I am terrified of having a total knee replacement on my other knee which is supposed to happen this summer.
I am scared to death about going ti the dentist because I was told that there is a possibly of infection , I had hip replacement two years ago I am 82 years old pretty in good health should I be scared to go to the dentist ......will just antibiotic taken before going to the dentist will eliminate my fear of gettiing an infection? I trust y0ur knowledge and I hope you answer my question
Are there any statistics kept on post surgery infection (for joint replacements)? I"m wondering what percentage of patients end up with a joint infection post op.
How well can the thickness of the crosslinked high density polyethylene pacer between the two metal parts of the knee be measured and how can they determine if microscopic polymer parts have separated from the said pacer?
Not sure what you mean by measured. We have multiple different sizes often 1-3 mm in difference. It is difficult to assess small amounts of wear of the poly but this can lead to symptoms and aseptic loosening. If you can see the wear on X-ray , it is a lot by then. Hope that helps
Thank you. I am having an x-ray done next week with an orthopedic doctor's visit afterwards . Your answer will help me better understand the results of the examination. @@TalkingWithDocs
What about the patella moving, plus infection? Several weeks after my knee replacement on my right knee, my patella moved into a space on the left of my leg, and the knee swole up to cantaloupe size. That was my first revision surgery.
@@TalkingWithDocs me too. My patella went far left, the surgeon oped it up to fix it, and found an infection. He cleaned everything out, replaced plastic bits, a sewed it up.
This is my greatest fear. Coming up on one yr post op RTKA and 8 mo post op LTKA. Taking antibiotic prophylaxis before dental cleanings religiously. My surgeon recommends life time prophylaxis and I’m on board. This cardiology NP is all in. Why take a chance.
Hi thank you so very much for these videos that are so informative!!!! 1. What are your current opinions regarding antibiotics and dental work after a knee replacement? I had knee replacement surgery this past October and unfortunately just before Christmas I had to have an emergency root canal done because of an infection. To my surprise there are differing opinions in both the dental and medical fields in regards to the use of antibiotics prior my dental work. Thank goodness the oral surgeon I was referred to believed in the importance of antibiotics prior to my dental work. 2. Public pools and the risk of infection. When is it considered safe to use public pools after a knee replacement?
So for dental work it is very controversial. Some say none. Some say life. We say 1 year and obviously for any abscesses etc. as for pools once the wound is 100 percent healed and no scabs.
Infection concerns me in part because my Methotrexate and sulfasalazine (for my RA) are both immunosuppressive. Do the RA drugs increase the risk a lot, and if I have to take antibiotics do I have to go off my RA drugs?
When I had my partial knee surgery, after four weeks operation I had bad reaction dressing allergy symptoms. Plus fractured my knee . I don’t know if damage during surgery. It was nightmare experience . I never recommended to anyone to have partial knee replacement . Not working. Now offer me only solution to full knee replacement. I’m so afraid and worried about to have another surgery. Any suggestions please ?
My mum had very bad infection in her knee replacement 6 weeks later . They gave her antibiotics but they was slow so they re~ opened the wound under anaesthetic clear the goopy stuff out and cleaned the joint and used seaweed in the wound and intravenous antibiotics, It worked!! ✨✨👌 ( she had MRSA and another infection I forgot the name of it.. )
Check out 'phages'. Phages are a virus that absolutely devours bacteria, replicating until all the bacteria is gone, then dies out. There are several million phages in a drop of seawater. I read about them in Popular Mechanics or Popular Science several years ago.. My wife had MRSA after a hip implant...lived with it until it required many medicated revisions. It remained, however when she had blood tests. After reading the article in the magazine, I shared it with my wife. We made a 300 mile trip to the west coast of Washington state, and brought back 2 gallons of INCOMING TIDE (freshest) seawater that she sipped on for 2 weeks. Two years later she tested negative for MRSA. That was 3 years ago...still negative. Read the article. It worked for her.
Question? for your i have surgeries on my knee about 8 to 9 cannot cure the infection on my knee. The quality of my life is not great. I won't have my leg amputated. So it quit hurting
Hi docs, may I ask a question? I recently had my hip replaced, and I wondered- as a surgeon do you have a better outcome on either left or right side hip replacements? Does a surgeon being left handed or right handed have any impact on outcomes? Just asking cos I’m needing my other hip and both knees - I’m imploding here 🙄😂
Plus I should say I’m not going to ask my surgeon that question- I don’t want to offend him! The first surgery was literally perfect- much easier recovery than I had anticipated- so good in fact that’s why I’m thinking maybe that was his best side 😅
I have had bilateral tkr in 2006 , absolotely no issue , very comfortable till march 2024 when there was a swelling below the left knee and in a few days it burst and there was tremendous exudate of pus . I was put on teicolomycin iv 3 days a week. I have ckd recently developed and take dialysis 3 days a week!! Had infection of mrsa during dialysis and the doctors are of the opinion that this could be a part of earlier infection . My infection has totally healedbut my tkr specialist who did my surgery is of the opinion to open my knee check if revision is required.my xrays shows perfect knee joint , mri is inconclusive. Can yu please advise if i can avoid revision ? Will i have to be on antibiotics for an extended period?
I had my right knee replaced 20 years ago. Some years ago I was in emergency and the doctor told me that it was beyond its lifetime and that was more than 2 years ago. How many more years can it last?
Thank you again. So I might have another five year to go . I am 78.5 years old and the thought of having to go to through a revision surgery is not very appealing. Let's hope I haven't to.@@TalkingWithDocs
Sometimes because your original surgeon ignores all your very serious symptoms for years, refuses to send you for any imaging tests other than an xray, and tells you to loose weight and exercise. Then you have to lobby SO HARD to see a new doc and get a CT scan that tells you that your implant is a mess. Then you have revision surgery by a 3rd doctor in another city and are on Cipro for life. Thank you for these very helpful videos. @TalkingWithDocs
Hi guys, Number 1 reason, why bacteria does not get destroyed, is because patient's immune system is not working well. They develop bacterial resistant on top of that. Patient's hygiene can be poor including their diet ( sugar and fructose that feed inflammatory processes), antibiotics now are cheaper and not strong enough to kill the resistant bugs. Amputation is extreme treatment but for low income people and younger than 65, in Ontario , artificial limbs will be paid, so therefore some people take advantage of our great universal health care in Canada Topic is unhappy for people that have pay tons of taxes 😊
That thumbnail alone will keep me away from the knife as long as possible. I have seen it before in person. I knew one fellow that had a small tube and plastic thing to keep it drained. Quite disgusting really. It did eventually heal up, but it took a while. I know someone else that had both knees done and swears by it, you just never know.
I like that you are sitting instead of standing, you guys stand on your feet in the o.r. all day. Glad to see your taking care of your joints. Thanks for all your advise.
Little purple bacteria guy was a great addition to your video. Although I take my antibiotics religiously before visiting the dentist, this is my greatest fear for 2 to 3 weeks after I see the dentist. Stay safe.
Wish I had a good story, but I'm laying in a hospital bed right now and I've been here for two weeks because of an infection of my recent total knee replacement that was done on January 25, 2024. I was told by the infectious disease doctor that came to see me that I would be on antibiotics for life. However, my surgeon said more like six months to a year. I then went back to the infectious disease doctor who hedged her bet a little bit and said well maybe six months to a year But she didn't sound confident
I was actually doing great after the initial surgery to replace my knee and didn't need my walker or a cane after one day I was able to do all my exercises and rehab the knee at home. Then 10 days ago out of nowhere I couldn't walk on the leg. It slowly started to swell and I got a fever and I had my son drive me to the emergency room where they transferred me to the original hospital where I had the surgery done so that the original surgeon could do the revision. I've been here ever since. I have to say that if I had to do it all over again, I would never do it. That makes me pretty sad because I was planning on doing my other leg as soon as the first one was rehabbed.
Anyway, sorry to be a downer and thanks for the video
I’m in the same boat. Doing well for 7 weeks , then boom. Infection.
Really Thanks for the Video, my Implant was affected with Prosthetic Joint Infection due to Loosening of the Implant which was not cemented at the time of Surgery a year ago. Later, after serious decisions with Senior and experienced Doctors, I went for Amputation my Leg 🦵 above Knee. I felt it was the correct surgery 😊 to be done on me undertaking my post 4 surgeries within 4 years.
@@sharoonjoseph3639 Wow! Sorry to hear about your amputation! But glad that you feel it was the right thing to do. Good luck with your rehab!!!
Hi, how are you know? Don't mean to be nosy, its just that mom had knee replacement in late June and currently is in the same stage now as you where when you posted this. Was hoping you can tell me a bit more about your process?
@@sharoonjoseph3639hey, can I ask why you never went for the antibiotic spacer? Or was it not an option for you? I had my replacement in February this year, ended up with an infection two weeks later. I have had three washouts since then and now have another infection and considering the spacer and new replacement. I am only 35 so considering this before I go for the chop like yourself! Hope you are doing ok! Sending my love xx
Fortunately I've never had knee problems, but my Dad had both done 5 & 6 years ago at UBC hospital here in Vancouver, thankfully both with great success. However, I do have a friend south of the border who has had painful ongoing issues with his knee joint replacement. I have shared your previous videos on this subject in hopes of providing some valuable information for him.
I love the way you guys explain things on your videos. Simple and to the point so the average Joe can understand. Makes a world of difference. 😊
I had MRSA infection in an eight year old hip replacement in March. I was in severe pain for about a week before surgery was done and it was cleaned out and plastic was replaced. I was on antibiotics via pic line in a rehab facility then at home for 7 more weeks until the CRP finally went t normal. Both my infectious disease dr and orthopedic surgeon who is a trauma surgeon say antibiotics for life. I’m on doxycycline 2x day. I pray I never go thru that again.
I agree. My wife going through he , with her recovery. 6 months.
Thanks Docs, 56 year old cop from Tasmania, Australia.
TKR on 15th Feb 2024, infection symptoms hit about week 7, Aggressive debridement 24th May 2024.
PICC line inserted for 6 weeks IV antibiotics and 1 week since and I fear the swelling , heat and tightness means it didn’t work.
Medical team are great. But it’s been a tough road so far.
Your videos are so great.
Hope my markers for infection come down, results should be in soon.
I'm so sorry! Hope U R better now. I possibly will have a TKR in a few mos. I've had sepsis MRSA in the past and was hospitalized for 6 wks., PICC line and everything like you, so I know how U feel. Hope I'll do fine. God Bless! I'm from the states.
Same for my husband 2 weeks in with antibiotics
Great video as usual! I had an infection in my prosthetic hip two years later. Another surgery, debridement etc. Followed by IV and oral antibiotics for 12 weeks. Doing fine now.
TKR 3/12 did well 5 weeks after developed chills headache fever really awful feeling temperature 101.9 it all happened at once
Went to ER treated me with antibiotics but ran all kind of testing for blood clots since leg was red and after 4 days went home on antibiotics dg cellulitis superficial and thank God resolved 🙏🏾🙏🏾
I’m so glad I looked up your videos. I literally watched the one from 7 years ago and then found this one!!!
I had THR on 12/21, yesterday I felt a wetness coming from my bandage took it off and my wound is leaking pus. My husband took pictures and I called my orthopedist today, I emailed them pictures and they prescribed antibiotics within minutes of the email and want to see me tomorrow. I’m definitely nervous about my visit but praying that the joint isn’t infected.
I’ve had 4 hip replacements, 2 on each hip. The last one was on sept 20. I had hip failure but had to wait over a year for surgery due to Alberta Canada’s terrible health care. I’m 69 years old. It was a rough surgery, my knee was damaged during surgery, surgeon who has no compassion said “sometimes things can get a little rough during surgery as we use your knee as an anchor, we may have damaged it”. It’s still swollen and painful. They did the debraidment found metalolsis non malignant cysts which they removed. My chromium/cobalt range were over 100. I also had a ham string tear and tendon rupture due to my long wait for surgery. Recovery has been slow this time, still using a cane and doing physio. My hip is still swollen but no pain. In addition 5 screws were added. I can feel them it’s a strange feeling. Also my leg is now longer. I’m a strong lady but I must say I’ve had enough of this. Thanks for all you do. I love your entertaining and informative vids. Learned a lot about many things. Happy New Year.
I have heard that you need to wait in Canada. If you are in a lot of pain or at high risk of needing surgery immediately, can you get it?
@@barbaraebner5889 no there is a long wait list for all surgery’s. There are private clinics in Edmonton and Calgary if you have thousands of dollars to pay for surgery.
Canada is the worst. I’m43 and I will be lucky to walk again.
@@barbaraebner5889 no you can’t you are put in a waiting list.
Same my hip is infected and my surgeon after 2 botched surgeries hands me off to a stranger, now because of the long wait and opioids they are gonna take my nursing licence away, and it made me so constipated that it hurts a hole through my intestines to my bladder so I’m peeing feces. Now I probably will have a colostomy bag and maybe a wheelchair after 3 major surgeries. I’m only 43 and I have not walked in years. I have a broken pelvis and nobody is doing anything. The second new surgeon in Toronto has not called me back. My liver enzymes are through the roof my platelets are down and my blood is like tomato juice. I’m probably dying. This was all caused by the security guard at the local hospital body slammed me on the cement on my hip with AVN. I reported it 2 years ago and nobody did anything. They will get away with all of this. I’m fighting on my own and my abusive mother who is 75 pushed me down on my hip and laughed. She broke her hand punching and now she has a cast. She was yelling get up you beep get up!!! She wanted me on my feet and she tried calling only the police but I screamed for the ambulance, they came and they didn’t charge her. If that was me I’d be in jail. She had done nothing for me my whole life and I have nobody. My family walked away from me after I took care of my dad for what !? So I could be homeless with no job and disabled. Oh well anyways that’s it.
I am over 7 years since my total knee replacement I deal with severe at times pain every day and I am on some potent medication I have been checked for infection and other things, my first surgery was in 1978 I had a knuckle of bone broke in my knee and it was pinned back with Smiley pins and I guess the wear and tear through life resulted in needing the TKR right now I am waiting to go see another surgeon for a second opinion on having an above knee amputation to try and get some quality of life, I am only 60 years old and not ready to sit in the rocker and go off my rocker quite yet. Here in NL we have some good doctors I hope I get one that will help me out. I really enjoy the content that you guys put out you give the information in a way that is easy to understand. Thanks for all you do.
Thanks Wayne. We wish you the best of luck
Thank you?? for the info, I have been following you guys for 3 years, and you have provided me with a great deal of knowledge, but can we just go back to discussing the excruciating discomfort and pain of post-surgery and physio, never thought I would miss those days, and now they seem like the good old days. My surgery is on Jan 19th, 2024, and I really want to thank you for what you're doing, I have come to rely on your information, and it really is greatly appreciated. Oh, and my wife who is a retired ICU and Nursing educator with a specialty in evidence-based practice says you're kinda ok too.
Ha that's funny about your wife. Best of luck on the 19th. So glad we could be part of your journey. You've got this !
What a very empathetic presentation. Thank you!
Spent 12 years doing Surgical Instrument Sharpening and Repair...Ortho Docs kept me busy....Love this content...
That's very cool! Welcome aboard
Very much appreciate the real scope of this. Clear description of the full range of treatments and possible, real-world outcomes. Also noted that you were more subdued in the typical humorous playfulnesses. Very appropriate.
I need a knee replacement, have an appointment in a couple days for a consult & now very concerned after seeing this video. I've read that infections are rare but it still doesn't give that warm & fuzzy feeling inside, especially after reading all the comments below, quite a few to be honest. Thanks for your videos, you both are so informative, many thanks.
Having had a total knee replacement 2 years ago and a total hip 2 months ago,this is a bit scary. I'm looking at my other hip replacement soon, and my other knee hopefully a few more years out. I hope I don't get it! So sorry for those that do. Wish you all the best!
Worked in PACU 30+ years, and it's so interesting to really get into the nitty-gritty of WHY these different procedures were done after the total joint became infected
Exactly I think I only had 3 rounds of antibiotics for my revision and protocol is 5. Also glued together twice that lead to poor healing and big Keiloid scar. I’m terrified I’m gonna die
I am going through this agony now on year #3 on a total knee replacement. Elevated CRP and ESR test results. Are there any videos of patients who have SUCCESSFULLY gone through a single or 2 stage surgery? Thank you so much for your excellent insights!
So we don't have any videos about patient cases but we have lots of patients who have gone on to cure their infections. Sorry to hear you are having such a tough go
I care for an 84yr old lady.. she is post knee revision x4 years but for last 2years has been on oral antibiotics. Now a red boil like wound has come up 3times in 3 months. ? Sinus tract infection. Do not know what might be best action. CRP and other labs normal. She had first revision due to this same infection process
Can you have a normal CRP and the joint is still infected
Patients with " leaky gut".
I think it's fair for surgeons to send patients to a internal medicine specialist first, so they can treat greatest route of bacterial infection. I really enjoy these educational videos. Keep up your good work.
I am scheduled for a revision surgery on my right total knee replacement on Nov. 27, 2024. I had a UTI that became septic and I was temporarily in renal failure. I also had a painful, swollen right knee. My kidney function has greatly improved but I had aspiration of my synovial fluid from my knee. The culture was e. coli and enterococcus faecalis. My original knee replacement was in 2012.
Thanks for answering this important question! But what do you tell your replacement patients about avoiding these infections in the first place? Do you recommend patients take antibiotics in conjunction with dental procedures, specifically cleanings? Is there a difference between ortho surgeons and the dental association in Canada? Apparently there is a differential here in the states...our surgeon told us we didn't want to be the few who have to have a revision based on an infection? How about simply cutting yourself? I use Betadine to clean any of those injuries to minimize the chance. Not trying to overthink this but could be important to all of us with replacements. Thanks guys!
I know someone that had a bone infection following a broken ankle and they went through all the sequence of trying different things and eventually ending with amputation. He was actually upbeat and relieved after the amputation because he could be done with the whole saga. So far, he seems to be doing well with his new prosthetic
Yes this can happen. Thanks for sharing the story Chris
When I was in hospital last 2022 the person in the bed next had an industrial accident and had to have his foot amputated. His new prometheus foot which was GPS controlled cost £65,000. I was told it changed it's own action depending if you were walking up or down hill. He was looking at million GBP compensation coming.
Thank you Dr Obaz, You’re such a wonderful doctor and you always make me feel so safe. The compassion with which you treat the patients is more effective than any medicine! God bless you doctor 💢
Thanks so much for this information! It’s very helpful! God bless you and your families🙏🙏🏻🙏
You are so welcome!
wonderful video with some great information. It seems even with the best possible outcome it's still a lot of work for the surgeon and a lot of time for treatment for the patient---antibiotics time included. I can't begin to imagine how hard it must be to completely replace a replacement, given they are put in to be permanent. And the amputation option---that one is so tough. But it sure bets dying from a very bad infection.
Thanks, I canceled my surgery today.
Thanks for all you do!
Love your informative channel! I’m a retired OR nurse. What about a terminally infected shoulder joint? Would you remove hardware and cement the joint like the hip (since amputation isn’t an option like a knee)?
Do you have some adhesive capsulitis? I had a shoulder fracture/dislocation with ORIF. Kept having pain. Original doc just told me to keep exercising.
Went for a second opinion. New Doc recommended an arthroscopy. Found severe adhesive capsulitis. And he also found I had sustained injury to my biceps tendon in the original injury so he did a biceps tenodesis.
I woke up from surgery with minimal pain and went on to complete PT and have not had any issues since.
Yikes! I now know my phone is listening to me. I'm having a 10 yo TKR revised and bone graft next month...
PTL ... I haven't had that problem! Thx for video! 😊
My sister had her second knee replaced over 2 years ago. She got an infection in that knee and unfortunately acquired sepsis for this. Then after they replaced the parts she came down with c-difícil. Such a horrible thing to go through. She is now on antibiotics for the rest of her life!
I am glad I found your videos.. A lot of informations.. Thank you
This is such an informative and excellent video. I’m very impressed with how much you were able to explain on the treatment of infected joint replacements from the ’mild’ to the ‘extreme’ in a short time. You gave percentage recovery details but gave little idea as to the frequency of serious infections. Have either of you had to remove the hardware in either hip or knee replacements? Towards the end the most serious outcome for the patient is amputation. However, this was followed by explaining that life-long antibiotic treatment,which carries risks, would enable the patient to keep the limb. However, surely life-long antibiotic treatment is preferable to losing a limb? I may be totally wrong! Question - Does the cement used when an implant is first inserted contain an antibiotic similar to the cement used second time round? Many thanks Docs for a really fascinating insight into the treatment of infection which may occur after a knee or hip replacement
HELP ! My mom went through a hip replacement no one not two not three but 5 times. The first four times no infection at all. Luxation was the problem. In fact last time they removed the whole thing. Last surgery was on 12/12/23.: Infection after two courses of antibiotics. It was clear to me that it was most likely because there was a super hole between the staples. The rest of the wound healed famously. But now there is almost a balloon. The fistula is a balloon. My mom is 82, diabetic, and hasn’t done a proper rehab. After watching your video (Thank you) gave me clarity but also anxiety. I don’t think she is strong enough to overcome another “cleaning surgery”.
Had a reverse replacement shoulder procedure 2 1/2 years ago and got a severe abscess in March. Out with the prosthetic, in with a cement spacer and on with 6 weeks of intravenous antibiotics. Six months later the spacer came out and I have a new reverse replacement prosthetic. Third surgery was easier to recover from and I have 90% of my mobility back. Worst part is sleeping upright for 6 weeks after surgery but we rented a hospital bed with a good mattress which made it bearable. I really appreciate you guys. I now need a knee replacement but I have heard some doctors are reluctant to install a new knee after this type of infection. What do you think?
Thanks, For being upfront with all your answers. I see a spiecalist this week. Tom
Hi Guys,
Love your videos and watched a ton of them prior to my TKR in Jan 2023. Rehab was going well however I unfortunately slipped off a step & tore my quad tendon, about 3cm, same knee at Easter. Repaired in May and seemed okay for a couple of months but seemed to loosen. Dr scheduled repair for Oct but got an infection late Sept. I am in the middle of the 2 stage replacement after the 6 week IV. New replacement due Feb 5. Sometimes you are just the 1 to get Sh't luck. I am more than optimistic as the ortho & infectious disease team here has been FAB
24 years old here, was in a really bad car accident back in 2015. Had my pelvis reconstructed, 2 hip scopes, had my first replacement in 2020 the a revision last year in January 2023. During the revision my surgeon found bacteria and turns out it was infected. I then had a midline put in for a month and everything was good. Fast forward to 5 months ago I start getting terrible pain.
Go back to the doctor, do all the tests, injections, you name it. Come to find out my total nucleated cells are at 4400. Going to see a different doctor in a few days to go over the 2 step surgery .
So sorry to hear that. Infections can be tricky. Best of luck
I had surgery on my right shoulder rotator cuff complete tear 5 anchors were put in. One week later, my incision broke open and started draining. My orthopedic surgeon took me back to the operating room did a washout with a drain in my shoulder 2 weeks after that first washout, Back in the hospital for second washout with another drain. Then six weeks of IV anabiotic’s every day. then three months of oral antibiotics. Amoxicillin twice a day. That was 2 years ago. today I am completely fine. Shoulder is fine. success. The infection was P. acne. Bacteria.
The infectious disease doctors took over after my washouts they were excellent. I had to go to emergency room for IV anabiotic‘s every morning at 8 AM for six weeks. The oral’s were just amoxicillin 500 mg twice a day for three months.
Now I am back in the gym lifting weights, I’m 100%. So glad that I had the surgery even with the infection. All the doctors took very good care of me.
I have a close friend who had this happen. He nearly died, so this is a very serious topic.
For me, the question is: What if your implants were only put in to stabilize things while a bone fracture heals, or with something like scoliosis surgery? If there is an infection then, is it possible to simply remove the hardware? Thanks!
I'm on the waiting list for a total knee replacement. This is scary stuff especially as my husband has been told he could need a partial amputation due to a chronic ulcerated foot which isn't healing. The idea that god forbid we could if unlucky both end up with amputations is horrendous
Yes that's horrible. It is very uncommon thankfully
Greetings Dr. Zal Zal and Dr.Weening. Many thanks for this video. I have a few people I know who are having hip or knee surgery, will advise them of this video. I had staph infection when I had spinal surgery in 1995. Thanks for all your hard work. Dr Zal Zal and Dr. Weening are great doctors.😊
My father had us hip removed and still won the war. I currently have a knee infection. I am part of the first part.
I think it would be interesting to talk about scar tissue and the removal with manipulation under full anesthetic, although this isn't an infection. I believe if it occurs it is usually around the 9-12 weeks after the operation. Mine started after 3 weeks and being a personal trainer I was able to realize that something with my progress (mobility) was not quite right.
Unfortunately, this happened to my sister. She had knee replacement and not long after the pain worsened. She returned to her doctor and was told that the pain would go away, she just needed to keep exercising… then gave her pain pills. Six years later, due to long term infection in the bone above and below her knee, her leg had to be amputated. I saw her struggle with both pain and pain pill addiction.
I’m scheduled for replacement the end of February, and greatly fear this happening to me.
Wow so sorry to hear this. It is exceedingly rare thankfully. Wishing you the best in February
Have you ever considered Red Light Therapy before and after the TKA. I have had both knees replaced now. Left one without red Light therapy. Right one with red light therapy.
The rate of healing of the right knee is far greater than the left knee. The scar on my right knee is minute less than paper thin. Where my left knee has a normal scar as seen on my father and other people. Both wounds looked the same 12 days after surgery when the staples were removed.
At 14 days after the operation on the right knee I had an urgent phone call from New Hall Hospital asking me how my wound was.
I replied "fine" what your problem. New Hall hospital replied something went wrong with the operating environment. Everyone operated on that morning have infections in their wound. My wound was almost totally healed except for 15 mm at the top which was weepy. Which soon disappeared, I was still using red light therapy.
If I was allowed to I could send you a photo of both knees together and the scar on the right knee is hardly visible.
Love This
Hello! Thank you for these videos that have helped me & my family understand my situation. After 7 years my TRKR became infected. Surgery phase 1 took place 9/25/24. I gave completed 6 weeks of antibiotics and am now on a 6 week antibiotic holiday before I see my surgeon again. Pain & swelling is starting to return and feels somewhat like it did when the infection first occurred. However, I have also recently switched from at home PT to outpatient PT. Should I be concerned? Is there a way to know if this is just from PT or if the infection is returning?
This is not uncommon. Only way to know is to aspirate it. Good luck
My Dad had a total hip replacement done in Jan. He has been struggling with it ever since and now it is infected. Seems like the infection has been there a long time already. He is scheduled for a step one of a 2 stage revision July 12. They are using an articulated spacer. I'm wondering what his expected level of function will be after the 1st stage while the articulated spacer is in place? Will he be able to walk, will he be very uncomfortable, etc? And advice is much appreciated! You alls videos have already been very helpful understanding the process!
Had left hip replaced in Nov 2023. Severe infection set in immediately after surgery. Pathogen was not identified. Went thru 3 additional surgeries surgeries to clean out infection and remove hardware and replace with antibiotic spacer. Infection spread to size of man's hand on front of hip. Weakness and tremendous pain. Patient was moved to Northwestern in Chicago for a month. Then one month of rehab at Shirley Ryan in Chicago. 10 months after surgery pain persists and patient can only walk for short distances before needing the aid of a walker. Real bummer ... hip replacement is NOT 'a piece of cake.' Surgeon informs that BEFORE second stage of revision, patient needs right hip replaced. Patient is skeptical of that order.
I am going through revision surgery due to infection from tkr. My surgeon put a spacer in with the second tkr. Infection is reducing. He has ordered a nickel piece which will be surgically inserted after 6 weeks of antibiotics and 3 weeks of antibiotics to ensure the infection is gone. Bit of a nightmare.
I had a deep tissue knee infection 7 years after a total knee replacement. It was supposed to be a 2 part revision. I had the first part of the revision in May 2023. I had an antibiotic spacer and a plastic piece bolted in place while I was given 2 IV antibiotics…one was vancomycin for 6 weeks. The vancomycin caused a kidney injury with my GFR dropping to 11 and my creatinine was 4.40. The infectious disease doctor kept my labs secretive for 3 weeks, by the time I was able to see a nephrologist the injury was not reversible and now 17 months later my GFR baseline is 22. Waiting until it drops to 20 for a kidney transplant. I have not completed the 2nd part of the revision because I will need antibiotics again and with the low GFR it isn’t advisable. They have never identified the bacteria that was in my knee. Please ask a lot of questions.
How common are knee implant infeinfections? 1 in 1000 knees, 1 in 10,000?
Hi! Question for the doctors.. I had partial knee replacement surgery two years ago and my surgeon suggests antibiotics before each teeth cleaning. FOR THE REST OF MY LIFE. I took them today as a matter of fact and my dentist told me just a couple hours ago that they are not needed beyond year two. Who is right?
I have the same question.
My surgeon said for the rest of my life. I am obeying my surgeon.
@@DanAshleyChicago just asked my friend - he's a dentist and had hip replacement and he is also a bit confused but will likely take antibiotics also rest of life. infection vrs side effects of antibiotics ? no brainer
Hello, I had a total knee replacement in 21 for two years. I went with the Pain unbearable kept telling the doctor something was wrong. Doctor just kept saying keep up your exercise and therapy. Took bloodwork to make sure no infection said nothing showed up after two years, he just finally said there’s nothing else he could do so he released me. I went for a second opinion this doc said, the femur was loose so he goes in Cements the femur to the hardware and makes sure everything else is tight after the surgery. I got a call six days later that I have a bacteria infection in the knee part which he did not replace he never replaced any of it he only cemented the femur to the part. Long story short I was on antibiotics for a year and now all they’re doing is checking my blood work for infection, which the infection did not show up in the blood work from the get-go and the second doctor even told me that the part had to be infected when they put it in with my first surgery how can I trust that the infection is gone since I’m still having so much pain, swelling and inflammation in my knee and CRPS
Hi doc’s. Wish I did this a year ago. M - 61 . First TKR get home from hospital no one told me how to prep my house in some items I would need. I’m going to PT on my schedule pushing it. No I gotta get extension inflection about a month into it. I’m just having ridiculous pain and it was warm to the touch and my PT guy basically called me, a wimp like I wasn’t doing the exercises. Kept going kept pushing had to talk to the doctor. Something wasn’t right took over two weeks for me to see him. You could just look at it and tell it was infected so he decides we’re gonna do that washout and try some new spacers get me on IV and some. A month or so after his second surgery the spacers collapsed on top of each other basically locked my leg up off the floor about 4 inches. The infection turn to Mersa it was so bad at the time couldn’t do surgery till I can get my numbers down had to live with it that day after day, worst pain ever. He took one x-ray and decided to send me to the revision specialist in Gainesville about 45 minutes away. Great doc. He thinks he can fix it in doing another wash get everything out. I probably got Mersa. When I came out of surgery and came to, and I saw my doctor he said they did the best that I could do with what was there didn’t know what the hell that meant to find out you drove the titanium rod into my FEMA, threw a piece of antibiotic cement down into my tibia, another six months or so on antibiotics IV and oral, about 5 to 6 months and I went back to him for a check up. He told me that the knee has been through in 18 months of trauma. It’s gonna take at least a year it now 2 1/2 years later, but still can’t walk 10 feet, pain is still constant it looks mutilated like I was in a bad accident still swollen. so last month, I had to go back to the Infectious disease doctor get him to sign off , a cardiologist stress test in a couple of hours to sign off so now I’m just waiting for them to call me and tell me what day for my operation. I’m sick to my stomach. I think of the possibility of getting another infection, back on the pick line I guess. Up to me I would just run into antibiotics JIC . I trust this doc in Gainesville. if anybody can make it work, it’s gotta be him. he the one who built it. I honestly believe that if my PT believe me about something being wrong and the pain after the first month and I didn’t have to wait another two weeks to see this doc and they just sent me up to the revision specialist. I would probably be golfing right now. You guys are great love watching your videos on hypochondriac so that kind of stuff I need to check in with you guys lol have a great day. I’ll let you know what happens.
C reactive protein showed high infection but has lower down a lot. We are trying to nurture her as best as we can. What lab analyses does she need to identify the bacteria? It is going to be 4 MONTHS!! This next 4/12/24. Thank you for your help.
How often does this occur?
My mom has had surgery to clean up the hip infection. She's now on antibiotics intravenously for 6 wks then 6 weeksof oral. She's got a wound vac on it too.
She wants to know how long she will have the wound vac on her hip? And how long she will be in rehab. Can you provide a general explanation of how much time this will take?
I am 2 yrs S?P) left TKA I was just diagnosed with a staph + infections. I am scheduled for surgery on 10/3/2024 to remove the old hardware and replace it, then a PICC line inserted for IV antibiotics. I am really scared right now. I worked so hard fo rmy rabge of motion and I'm afarain I won;t get as good results this time.
How about University of Texas SW RF INDUCTION OF HEAT TO PROSTHESIS
Not sure what you mean - as a treatment? There are lots of ways to help reduce infection risk
I had a couple of laprascopic operations and the incisions were infected I poured peroxide on them they cleared up over night.
The bacteria I had formed a film on the implant which wouldn’t budge even with vancomycin & 3 others. I had a total revision surgery.
Yes the glycocalyx can be an issue for sure. Hope you are ok now
How do you find a revision specialist? Who refers you to one?
I wonder if this applies to having an ACL Allograft? I am 6 weeks post op and STILL battling an infection! The swelling is stopping my rehab, and I am frustrated with the surgeons lack of concern. Now I am terrified of having a total knee replacement on my other knee which is supposed to happen this summer.
I am scared to death about going ti the dentist because I was told that there is a possibly of infection , I had hip replacement two years ago I am 82 years old pretty in good health should I be scared to go to the dentist ......will just antibiotic taken before going to the dentist will eliminate my fear of gettiing an infection? I trust y0ur knowledge and I hope you answer my question
Are there any statistics kept on post surgery infection (for joint replacements)? I"m wondering what percentage of patients end up with a joint infection post op.
How often does this really happen at Halton Healthcare? Has to be pretty rare.
What precautions do you take either before or during joint replacement surgery to prevent infections?
How well can the thickness of the crosslinked high density polyethylene pacer between the two metal parts of the knee be measured and how can they determine if microscopic polymer parts have separated from the said pacer?
Not sure what you mean by measured. We have multiple different sizes often 1-3 mm in difference. It is difficult to assess small amounts of wear of the poly but this can lead to symptoms and aseptic loosening. If you can see the wear on X-ray , it is a lot by then. Hope that helps
Thank you. I am having an x-ray done next week with an orthopedic doctor's visit afterwards . Your answer will help me better understand the results of the examination. @@TalkingWithDocs
I'm currently going through disinfection with knee irrigation and antibiotics. It is rough
If you have questions I'll answer if I can
i had 3 knee replacements and 4 infections so far
Hi, Message
So you got rid of the infection each time?
Can Core decompression surgery help AVN patient (Stage 1/2)
Yes potentially. Results vary but options are quite limited for this group
What about the patella moving, plus infection? Several weeks after my knee replacement on my right knee, my patella moved into a space on the left of my leg, and the knee swole up to cantaloupe size. That was my first revision surgery.
Hmmm not exactly sure what you mean. Hope it's ok now
@@TalkingWithDocs me too. My patella went far left, the surgeon oped it up to fix it, and found an infection. He cleaned everything out, replaced plastic bits, a sewed it up.
have samenone who have total hip revision implant removed but wound is infected with staphyloccus isoleted
This is my greatest fear. Coming up on one yr post op RTKA and 8 mo post op LTKA. Taking antibiotic prophylaxis before dental cleanings religiously. My surgeon recommends life time prophylaxis and I’m on board. This cardiology NP is all in. Why take a chance.
There you go Karen!!
Can a knee replacement aggravate the sciatic nerve?? It's been 3 weeks and after 2 weeks mine really hurts. It keeps me awake.
Hi thank you so very much for these videos that are so informative!!!!
1. What are your current opinions regarding antibiotics and dental work after a knee replacement?
I had knee replacement surgery this past October and unfortunately just before Christmas I had to have an emergency root canal done because of an infection. To my surprise there are differing opinions in both the dental and medical fields in regards to the use of antibiotics prior my dental work. Thank goodness the oral surgeon I was referred to believed in the importance of antibiotics prior to my dental work.
2. Public pools and the risk of infection. When is it considered safe to use public pools after a knee replacement?
So for dental work it is very controversial. Some say none. Some say life. We say 1 year and obviously for any abscesses etc. as for pools once the wound is 100 percent healed and no scabs.
Thank you😊
Thanks for asking my questions & thanks to the docs for their answers.
Dealing with this with my RTHR 😢
So sorry to hear this Kerri. There is hope!
@@TalkingWithDocs I wish I was in your area .. this is so frustrating and scary
Infection concerns me in part because my Methotrexate and sulfasalazine (for my RA) are both immunosuppressive. Do the RA drugs increase the risk a lot, and if I have to take antibiotics do I have to go off my RA drugs?
Why do they not give antibiotics right after surgery to prevent this?
When I had my partial knee surgery, after four weeks operation I had bad reaction dressing allergy symptoms. Plus fractured my knee . I don’t know if damage during surgery. It was nightmare experience . I never recommended to anyone to have partial knee replacement . Not working. Now offer me only solution to full knee replacement. I’m so afraid and worried about to have another surgery. Any suggestions please ?
My mum had very bad infection in her knee replacement 6 weeks later . They gave her antibiotics but they was slow so they re~ opened the wound under anaesthetic clear the goopy stuff out and cleaned the joint and used seaweed in the wound and intravenous antibiotics, It worked!! ✨✨👌 ( she had MRSA and another infection I forgot the name of it.. )
Check out 'phages'. Phages are a virus that absolutely devours bacteria, replicating until all the bacteria is gone, then dies out. There are several million phages in a drop of seawater. I read about them in Popular Mechanics or Popular Science several years ago.. My wife had MRSA after a hip implant...lived with it until it required many medicated revisions. It remained, however when she had blood tests. After reading the article in the magazine, I shared it with my wife. We made a 300 mile trip to the west coast of Washington state, and brought back 2 gallons of INCOMING TIDE (freshest) seawater that she sipped on for 2 weeks. Two years later she tested negative for MRSA. That was 3 years ago...still negative. Read the article. It worked for her.
Very cool! I've never heard of sea weed to treat infection before
Question? for your i have surgeries on my knee about 8 to 9 cannot cure the infection on my knee. The quality of my life is not great. I won't have my leg amputated. So it quit hurting
Is it an antibiotic resistant bacteria?
Most often no thankfully. But if it is it does increase the chance of requiring multiple procedures or not being curable
Hi docs, may I ask a question? I recently had my hip replaced, and I wondered- as a surgeon do you have a better outcome on either left or right side hip replacements? Does a surgeon being left handed or right handed have any impact on outcomes?
Just asking cos I’m needing my other hip and both knees - I’m imploding here 🙄😂
Plus I should say I’m not going to ask my surgeon that question- I don’t want to offend him! The first surgery was literally perfect- much easier recovery than I had anticipated- so good in fact that’s why I’m thinking maybe that was his best side 😅
We would say no
@@TalkingWithDocs thanks for your reply. Good to know 😁
I have had bilateral tkr in 2006 , absolotely no issue , very comfortable till march 2024 when there was a swelling below the left knee and in a few days it burst and there was tremendous exudate of pus . I was put on teicolomycin iv 3 days a week. I have ckd recently developed and take dialysis 3 days a week!! Had infection of mrsa during dialysis and the doctors are of the opinion that this could be a part of earlier infection . My infection has totally healedbut my tkr specialist who did my surgery is of the opinion to open my knee check if revision is required.my xrays shows perfect knee joint , mri is inconclusive. Can yu please advise if i can avoid revision ? Will i have to be on antibiotics for an extended period?
I had my right knee replaced 20 years ago. Some years ago I was in emergency and the doctor told me that it was beyond its lifetime and that was more than 2 years ago. How many more years can it last?
It is hard to say. We have seen beyond 25
Thank you again. So I might have another five year to go . I am 78.5 years old and the thought of having to go to through a revision surgery is not very appealing. Let's hope I haven't to.@@TalkingWithDocs
What a nightmare...how does this happen ??
Well bacteria is everywhere. Sometimes from the skin or a UTI or pneumonia or a dental abscess
Sometimes because your original surgeon ignores all your very serious symptoms for years, refuses to send you for any imaging tests other than an xray, and tells you to loose weight and exercise. Then you have to lobby SO HARD to see a new doc and get a CT scan that tells you that your implant is a mess. Then you have revision surgery by a 3rd doctor in another city and are on Cipro for life. Thank you for these very helpful videos. @TalkingWithDocs
My mom is on surgery #4 on her hip because of infections. 😮😢
Sorry to hear this. Hope it can get cured
Hi guys,
Number 1 reason, why bacteria does not get destroyed, is because patient's immune system is not working well. They develop bacterial resistant on top of that. Patient's hygiene can be poor including their diet ( sugar and fructose that feed inflammatory processes), antibiotics now are cheaper and not strong enough to kill the resistant bugs.
Amputation is extreme treatment but for low income people and younger than 65, in Ontario , artificial limbs will be paid, so therefore some people take advantage of our great universal health care in Canada
Topic is unhappy for people that have pay tons of taxes 😊
Sounds like a nightmare
How are doctors gonna have a grammar error on their title….😂
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Thanks
Hello you are
Flush with hydrogen peroxide, iodine, and colloidal silver
Yes we do that. Minus the silver.
That thumbnail alone will keep me away from the knife as long as possible. I have seen it before in person. I knew one fellow that had a small tube and plastic thing to keep it drained. Quite disgusting really. It did eventually heal up, but it took a while. I know someone else that had both knees done and swears by it, you just never know.
OMG, no he didn't get them done at the same time. That poor darlin, that had to be awful.@JimAllen-Persona
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Thanks