Two stage hip revision from infection.
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Hi my names matt I'm new to this site. Looking for any advice or information I can get towards my situation. I underwent a left total hip replacement on November 24th of 2015 at 28 years of age due to bone on bone pain from arthritis and bone spurs. My surgeon believes I tore the labrum in my hip about 10 to 14 years ago playing football. The surgery was painful but I recovered fairly quickly I was able to jog without a ton of pain after 6 weeks. Jump ahead a year and a half to April or 2017. I developed severe pain in my left hip again and went back to the hospital where they aspirated my hip to discover I had an infection a form of staff. They had to remove my hip replacement break the spike out the femur and the titanium cup out of the acetabulum. They inserted a temporary antibiotic cement spacer. I underwent 6 weeks of iv antibiotics. Then after 6 weeks they re-aspirated the hip to learn it was still infected. I underwent another 6 weeks of iv antibiotics, another 6 weeks off. The aspirated again and the infection was gone. Doctor wanted to wait another month then aspirated again to make sure we were good before he put the hip back in. That's where I'm at right now. I'm scheduled for surgery on January 17th for the last surgery hope to god. But I have many concerns. My surgeon told me not to torture myself with pt since I could not advance to far with the spacer and to not cause myself to much extra pain. I have done some pt anyway and tried weight shifting as much as possible to prevent my leg from being completely atrophied from the past 8 months. In the meantime it has become winter here in New England and I had a fall on the ice last week. I was thankful after my fall that I did not hurt my hip bad. But two days later and my hip was very sore and I can't do the excersiozes I was able to just recently. I'm concerned About going into get a new hip when my leg is so weak. Last time I had the first the I was in pain but much stronger I was able to walk. I can only toe tap now. Is it ok to get my hip put in while I'm this weak. I'm only 30 years old do any of you think I will b able to get to walk again without a terrible limp. Iv read a lot about hgh doing wonders for surgery recovery, anyone have experience with this. I quit smoking ciggarettes and just started the paleo diet. I'm trying to make myself as healthy as possible. Any insight would be greatly appreciated.
0 likes, 34 replies
jimbone matthew33716
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Mathew-
I can't really advise you as I'm waiting to get surgery this year but I understand your concerns about being as health as possible. Even if you can't do leg exercises, if you can do upper body strengthening it would probably help to remaining as fit as possible. Good to hear you quit the smokes- good oxygen levels will speed your recovery. The hgh idea is worth further consideration however my understanding is that the stuff available online is mostly ineffective. The genuine thing is injectable and very expensive, likely not covered by insurance. Worth a talk with your doctor about it though. Going to consider that avenue for myself as well. Hang tough- you've had some bad luck but you sound tough enough to tough it out. Best to you.
Jim
RichardKen matthew33716
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Dear Matthew
Very sorry to hear of your latest concern. I understand your concerns but what is the alternative to putting back a prosthesis?
I'm sure that provided that infection is not an issue in the future that it will be OK though it is likely to take an extended time to get muscle strength back.
Very best of good luck. Richard
matthew33716 RichardKen
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Your right Richard I know that I must get back the permanant prosthesis. I guess there's no way to really improve till it's in there. I guess I'm just wishing my leg was stronger and didn't have so much pain after 8 months with the spacer. When I talk to my doctors it seems as if they think I'm far more weight baring then I Am and that my pain is higher then they think. They told me they have Patiemts before that didn't want to go through the next surgery bc they could walk ok on the spacer and things were fine. But for me I can't imagine wanting to leave this in. I havnt been able to put even 50 percent of my weight on the left leg this whole time. I'm wondering if my legs just that far gone that even the next hip replacement I won't be able to walk on
RichardKen matthew33716
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We both know it is going to be tough but once you have accepted that it needs to be done you can be determined to win through.
Good luck, Richard.
brenda67955 matthew33716
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I had asked my doctor what to expect with the new hip after having the spacer Lot of patience just get used to the spacer but when they get the hip they say oh so this is what it's supposed to feel like and it's so much better. Leg pain hand spasms kept me up all night again. I cannot understand why anyone would want to just keep the spacer in for my own well-being I need to get back to work I need the social interaction
brenda67955 matthew33716
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matthew33716 brenda67955
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It sounds like were going through almost identical situations. I'm also In mass having surgery at newton Wellesley hospital. It might be beneficial to both of us to keep updating each other. See if we could learn anything that might be helping
claudia95892 matthew33716
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matthew33716 claudia95892
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Thanks Claudia I do have a pool at home so the summertime I'm good. I have heard of the benefits of pt in the water. I'll be giving everything an effort I possibly can. Can i ask you how far out from surgery are you? How long did it take to get to where you are now. I understand everyone's different and not to expect the same results. But I'm still curious especially since you had it done around the same age as me
terrie_77563 matthew33716
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I am 2 weeks post op and recovery has been going well, a few hic ups but nothing like your unfortunate circumstances.
Take care and go slow
margot50 matthew33716
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First of all, may I ask how did you manage to get an infection in your hip a year and a half after your hip replacement? That seems unusual to me.
matthew33716 margot50
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I'm not sure Margot. They said it's hard to know what exactly happened. BActeria can enter your body through a small cut on your body, or from even flossing your teeth. I wish I knew exactly bc itv
matthew33716 margot50
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Because it has had me puzzled. I'm just hoping the pain I'm experiencing right now. Is from falling last week and it took a few days to hurt bc it shifted just a little in there. I'm probably going to call today and move my aspiration up. If it is infected again I know it gets worse and worse so fast. To the point it has taken me 45 minutes to get in a car to go to the hospital. So I need to move quick just in case. I'll b completely puzzled if it's infected again. My body can't take much more of this.
claudia95892 margot50
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RichardKen claudia95892
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Dear Claudia
I tackled my dentist five years ago about this after my TAR was told that it was no longer appropriate as a matter of course. I'm in the UK.
Cheers Richard
michael11283 claudia95892
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I too talked to my dentist and surgeon aboiut this. My surgeon (who specialises in bone infections) said that we are exposed to different bacteria many times every day. Our bodies have natural defenses that deal with these bacteria but occasionally the bacteria get past these defenses and lodge in the space between the bone and metal.
I have a titanium dental implant so was worried about potential infection from there.
My surgeon is very careful about possible sources on infection before and during surgery. In addition to MRSA swabs and pre op washes he tries to minimise the use of drains as these are a potential entry point and dressing changes.
Prophylactic antibiotic use is not common in the UK any more (when I broke my hip in the 70s everyone had antibiotics post surgery)
Infection is, fortunately, not very common (about 1%) and most are shortly after the surgery sio presumably enter via the wound.
Mike
ptolemy michael11283
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margot50 claudia95892
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Claudia, thanks for addressing the question. Two dentists I have spoken with told me they no longer recommend antibiotics prior to dental work like cleaning or even fillings. Not sure about more invasive things like root canals. My surgeon's post-surgery advice still had the recommendation in their instructions, but dentists these days are saying it is unnecessary. What is unusual is developing an infection in the hip joint a year and a half post surgery without some other infection being known about in the body. I was screened for MRSA before THR fortunately and was happy the hospital was checking that with patients. I hope Matthew can proceed with his surgery and let's hope he doesn't have any infection. Young people do so much better with surgeries.
margot50 matthew33716
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You're going through an awful time unfortunately. Hopefully the pain is from your fall and nothing more.
Good luck with the aspiration and keep us posted. Take care to avoid falls as best you can until your surgery.
brenda67955 claudia95892
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michael11283 margot50
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Infection long after surgery is less common but mine probably started 6 years post op and was about 2 before I realised and it was diagnosed.
I agree that Matthew has age on his side so should make a good recovery
Mike
michael11283 ptolemy
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Yes, that was what my dentist said when I asked him about root canal work
Mike
michael11283 matthew33716
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Matthew
I would imagine that the spacer is fairly well fixed in the femur and that it was the end pressing against the acetabulum that moved. I'm sure that would be quite painful.
Are you still having blood tests? That should show if the infection has returned. My surgeon did say that they only knew for certain when they opened the leg to put the new hip in. If there had been some residual infection they might wash it with antibiotics and put me on a course for a while. I think a residual infection after months of antibiotics is only a very remote possibility and in your case the infection doesn't sound like it had been there for as long as mine so you should be OK on that front.
But my spacer did get painful when I overdid things. I tried swimming but put too much weight on it in the shallow end. And when I tried the exerise bike. Both times it was sore the next day.
Mike