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Two stage hip revision from infection.

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matthew33716
matthew33716

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.

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  • jimbone
    jimbone matthew33716

    Posted

    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
    RichardKen matthew33716

    Posted

    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
      matthew33716 RichardKen

      Posted

      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
      RichardKen matthew33716

      Posted

      Dear Matthew

      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
      brenda67955 matthew33716

      Posted

      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
    brenda67955 matthew33716

    Posted

    I got a staph inf and spacer 7 weeks after thr. I was in rehab 6 wks and have been home for 5 wk. Waiting for aspiration to see if i can do the hip surgery soon. I can do almost no exercise and can only walk with a walker. I am having the surgery at N E Baptist in Boston.
    • matthew33716
      matthew33716 brenda67955

      Posted

      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
    claudia95892 matthew33716

    Posted

    Hi Matthew, the good thing is that the infection is gone. Are you able to get to a pool and do exercises in the deep end? I had severe atrophy on my right hip and the muscles are coming back. The limp is almost gone and I am pain free. I had my first hip replacement at 30. Good luck on the 17th. Stay healthy so they do not reschedule.
    • matthew33716
      matthew33716 claudia95892

      Posted

      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
    terrie_77563 matthew33716

    Posted

    Holy cow , all I can say it may thus round go well for You my friend.

    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
    margot50 matthew33716

    Posted

    Hi Matt, sorry to hear of your difficulties. You are young which will help you tremendously in getting through this.

    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
      matthew33716 margot50

      Posted

      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
      matthew33716 margot50

      Posted

      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
      claudia95892 margot50

      Posted

      Hi Margo,. My dentist states that every time I get my teeth cleaned or have any Dental work, I have to take antibiotics 1 hr prior. The issue is that bacteria can enter the blood stream and will travel to any prosthesis. Then our bodies react and mount a war against the infection but also the foreign object. If I get a fever I am to go to my family doctor right away. By the way I caught MRSA at the hospital and it took 3 sets of antibiotics to get rid of it. I had to wipe my whole body with special wipes . There was an outbreak of it,the month before my surgery. I was told that most hospitals have it and now in Canada, they get your nose swab to confirm if you are a carrier.
    • RichardKen
      RichardKen claudia95892

      Posted

      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
      michael11283 claudia95892

      Posted

      Claudia

      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
      ptolemy michael11283

      Posted

      Hi Mike, I believe recent research has found that post operative antibiotics do not reduce the rate of surgical-site infections compared with placebo, which is interesting. 
    • margot50
      margot50 claudia95892

      Posted

      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
      margot50 matthew33716

      Posted

      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
      brenda67955 claudia95892

      Posted

      I had knees and a gip done in Boston. The surgeon said i will need antibiotics before ANY dental procedure for the rest of my life! He said not to let anyone tell you differently. If a dentist refuses then find another dentist. Luckily, mine has had me pre treating since the first surgery.
    • michael11283
      michael11283 margot50

      Posted

      Margot

      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
      michael11283 ptolemy

      Posted

      Ptolemy

      Yes, that was what my dentist said when I asked him about root canal work

      Mike

    • michael11283
      michael11283 matthew33716

      Posted

      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

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