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Joint infection with pain 5 months after Anterior hip replacement

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lynne56429
lynne56429

MRI after 5 months THR with debridement of wound x 5 weeks out s/p 4 weeks abx rx IV. CRP, ESR now elevated with MRI reflecting fluid within joint as well as severe pain. Should I go directly to a revision center or have my joint tapped/ irrigated / treated here? And what center?? I live in Milwaukee 

0 likes, 5 replies

5 Replies

  • maggie93798
    maggie93798 lynne56429

    Posted

    In  the UK they often try irrigating  the wound after  isolating  the offending organism. Then if that is not effective the implants are removed, more irrigation before the revision
    • lynne56429
      lynne56429 maggie93798

      Posted

      Thank you! I have an office visit with my orthopedic today. Also will involve my infectious disease doc as well .
  • michael11283
    michael11283 lynne56429

    Posted

    Lynne

    How awful. In don't completely understand your situation (not very good on abbreviations) But as I understand it you THR is infected 5 months after it was put in.

    My hip got infected when I had bowel surgery so I did at least get 8 years out of it.

    It may well be that an infection diagnosed so quickly will be easier to treat. In my case I was told that once the infection has lodged between the metal and the bone, where there is very little blood supply, the joint needs to be removed for the infection to be treated.

    I went to a bone infection specialist centre. I am lucky that there is one very close to where I live in the UK. They did a two stage revision. So took the metalwork out, treated me with antibiotics and then put a new hip in.

    Hopefully in your case they may be able to treat it without such a procedure.

    The two stage is quite lengthy as you need 8 weeks between stage 1 & 2 (though in my case NHS waiting lists dragged that out to 4 months.) I was reasonably mobile partial weighbearing during that time and am now recovering. They had to cut away some of my bone because the infection had been there for so long. As a result my recovery is a bit slow but I'm 4 months on, walking quite long distances with a stick and cycling for up to an hour. I've told my surgeon (who is a cyclist) that I'm hoping to do 70 mikes on my bike in May next year on my 70th birthday.

    Hope you get your problem sorted

    Mike

    • lynne56429
      lynne56429 michael11283

      Posted

      The worst part at present is that they don’t know if it’s infected or not- my MRI showed nearly every area muscle inflamed, my Sed Rate and C Reactive Protein jumped from normal values to high indicating ‘inflammation’ (or infection) and yesterday they tried to tap the small amount of fluid in my joint for bacteria or cells explaining the severe pain. This is my second hip, and nothing has felt right from the beginning with this one. But you give me hope!! Thanks for the encouragement!!
  • michael11283
    michael11283 lynne56429

    Posted

    Lynne

    They didn't do an MRI to diagnose me. They did an x-ray and you could see the infection on the x-ray, They thgey took a sample which they did with a large syringe. The cultivated the sample to find out what the infection was. Interestingly having discovered what it was and which antibiotics it was susceptible to the didn't give me antibiotics until they took the old hip out. My surgeon wanted to open up the hip and take samples from various places in case there was more than one type of infection. I see the logic though it sounded odd at first.

    I know it's not in the USA but the Nuffield Orthopaedic Centre has a pdf which gives some useful information. I can't send you the link but if you do a search for prosthetic-joint-infection.pdf you will probably find it as well as some US information,

    Mike

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