What’s The Surgeon’s Complication Rate
Getting specific information on individual physicians can be difficult, but your surgeon should know his or her overall complication rate, which includes not only infections but also things such as developing a blood clot or pneumonia soon after the procedure.
The average complication rate for surgeons performing knee replacements on patients 65 and over is about 3 percent you should look for a surgeon whose rates are below that.
And again, think twice about a surgeon who doesn’t know, or won’t share, that information.
To Prevent A Knee Infection
Before and during knee replacement surgery, the following steps may help reduce the risk of infection:
- Using prophylactic antibiotics: Preventive medicines may help reduce the risk of knee replacement infection.
- Using antibiotics: These should be given immediately before, during, and after surgery for up to 24 hours.
- Keeping operation time short: A short operation time reduces the length of time the wound is open and vulnerable to infection.
- Reducing the number of people present: Limiting the number of people and limiting the number of times they come and go may reduce the bacteria in the room and decrease the risk of infection.
- Using sterile equipment: The theatre, instruments, and artificial joint should all be sterilized.
- Screening for bacteria in the nose: If a person has certain types of harmful bacteria in their nasal passage, they may increase the risk of infection. Some hospitals screen for these bacteria before operating. If harmful bacteria are found, the person will be given an antibacterial ointment to use. Some medical centers will routinely decolonize nasal passages with mupirocin several days before surgery.
- Washing with chlorhexidine: This may help reduce the number of harmful bacteria on the skin before surgery.
After knee replacement surgery, you may help reduce the risk of infection by:
What Are The Signs Of Knee Replacement Failure
The most common symptoms of a failed knee implant are pain, decrease in joint function, knee instability, and swelling or stiffness in the knee joint.
Persistent pain and swelling can indicate loosening, wear or infection, and the location of the pain can be all over the knee or in one particular area . A decline in knee function may result in a limp, stiffness or instability. Patients who demonstrate these symptoms and signs may require revision joint surgery.
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Total Knee Replacement Infection After 9 Years
I recently had an infection on my total knee replacement, they went in and clean the infected area. I was on 6 weeks of Vancomycin antibiotics through a PICC line, and afterwards, the doctor stated that I would have to be on a low dose of antibiotics for the rest of my life, that it was the new recommendation from the AMA. I have not been able to find that info in the AMA website and my concern is the side effects of taking antibiotics for the rest of my life. Has anybody gone thru a similar infection and is presently on antibiotic for the rest of their life? Thank you
Hi @rguribe Welcome to Connect. That is so scary that you developed an infection 9 years later. I’ve had 2 TKR’s one in 2017 and one earlier this year. I never dreamed that an infection could develop after so many years. You must have been devastated. My doctor has told me I have to take antibiotics before teeth cleaning for the rest of my life, but its just 4 amoxicyllin ever 6 months so it’s not the same as your situation. While we are waiting for others to chime in, can you tell me what the rest of your recovery was like? Were there extenuating circumstances or did this kind of hit you out of the blue?
Looking forward to hearing more from you. I can definitely understand your concern with taking antibiotics forever. I will be interested in hearing what you can find out about that also.JK
Did you also have a revision surgery?
The Second Knee Replacement Surgery
All of this also brings up a critical issue, when young people get a knee replacement, what happens when they need a second procedure? As a physician, I know that while the first surgery may take 60-90 minutes, the second knee replacement is a 2-4 hour affair. Why? Parts of your body have grown into the prosthesis and all of that has to be carefully dissected out so that complications like serious nerve or blood vessel injury dont happen.
We also know that the size of the bone tunnels must be expanded. Meaning that the new prosthesis needs fresh bone to latch onto, so the doctor has to ream out the existing tunnels and make them bigger.
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Why Does My Artificial Knee Hurt
The majority of people who undergo knee replacement have returned to work in six months or less. It is normal for pain and soreness during healing to occur, but there may be some minor discomfort. If you suffer from severe pain following knee replacement surgery, consult your doctor.
A knee is made of a metal structure and a plastic material, according to the terms of the procedure. The knee is replaced because it has been severely damaged by arthritis in the past. It is not uncommon for your artificial knee to make clunking and clicking sounds. More than 90% of those who undergo surgery report significant pain relief. You will most likely experience swelling and warmth in your new knee. People who exercise frequently report mild warmth as soon as they stop working out. After knee replacement surgery, there is usually mild to moderate stiffness. Speak with your surgeon if youâre concerned about the condition of your knee.
Can You Still Have Arthritis After Knee Replacement
Arthritis can be treated with knee replacement surgery. It may be able to repair the damage caused by arthritis and alleviate pain caused by the condition, but it cannot cure it.
This common treatment has a 95% success rate, and it relieves pain and stiffness. The quality of life can be greatly improved in a person who requires knee replacement surgery. The term arthritis encompasses all joint pain or arthritis. The Centers for Disease Control estimates that 22.6% of adults in the United States have arthritis that has been diagnosed by a doctor. Surgery to replace knees does not cure arthritis. In addition to correcting the damage done to the body by arthritis, this treatment can also alleviate pain associated with the condition. Itâs critical to maintain a healthy diet and exercise routine after knee replacement surgery. It is critical to ensure a strong rehabilitation program following surgery in order to have a successful recovery.
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Treatment Of Joint Infection
Treatment is easy when caught early to a superficial infection or infections just affecting the soft tissues of the joint or the skin but not yet has deep down into the artificial joint itself. Treatments include oral antibiotics or intravenous antibiotics both routes have a high success rate. For an infection that gains a deeper access into the body and hits the joint itself, more times than not, require beyond the superficial tissues and gain deep access to the artificial joint almost always require surgical treatment.
Debridement Surgical washout of the joint can cure deep infection or infection within several days. This procedure is known as debridement, and the surgeon performing the procedure will remove all of the soft tissues that are contaminated. The next step will be replacing plastic liners and a thorough cleansing of the implant and the spacers. After the procedure, a patient will take IV antibiotics for approximately 6 weeks.
Staged surgery As a general rule of thumb, the longer lasting infections or the longer one is present, the more of a challenge it is harder it is to treat without a removal of the implant.
Late infections, or those that show up months to even years after a hip or knee joint replacement surgery and those infections that have been present for longer periods of time, will generally require a staged surgery.
Hip Or Knee Replacements Infection Statistics
Infection is a rare, but serious complication after total joint replacement surgery. It occurs in one to three percent of patients nationally though, our most recent review of infection data at the University of Utah Center for Hip and Knee Reconstruction showed an infection rate better than the national average at 0.5 percent .
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Preventing Knee Replacement Infections
The foremost priority of knee replacements is to prevent infection from occurring at all. Some of the risks of developing an infection can be managed in a way to help lower the impact of these factors. For example, efforts to improve nutrition, reduce tobacco use, and discontinue medications that may make patients more susceptible to infection can all be done prior to undergoing knee replacement surgery. In the operating room, efforts are made to sterilize the skin and surgical area and minimize people coming in and out of the room. Intravenous antibiotics should be given within 1 hour from the start of surgery to ensure the lowest risk of infection.
Problem: Fixing Pain After Total Knee Replacement May Include Amputation
Three in 1000 patients will need to have their leg amputated.
The causes of the amputation were:
- infection around the implant ,
- circulatory damage .
In 80% of the cases, there were more than 2 of these factors for amputation.
In research from April 2017, doctors writing in the European Journal of Orthopaedic Surgery and Traumatology wrote:
Treatment for prosthetic knee replacement is becoming more common. Infection is an arthroplasty-related complication leading to prolonged hospitalization, multiple surgical procedures, permanent loss of the implant, impaired function, impaired quality of life, and even amputation of the limb.
The purpose of this study was to identify risk factors for amputation in the periprosthetic infected knee through a case-control study, analyzing patients treated from January 2012 to November 2016 in a hospital with a high incidence of this diagnosis. We included 183 patients with periprosthetic knee infection 23 required amputation as definitive management .
They found that patients with:
- Increased surgical time > 120 min,
- diabetes mellitus had an increased risk of amputation.
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Knee Replacement Surgery: Causes Of Early Post
If you are experiencing pain after knee replacement surgery, you must first determine what is causing it. The presence of infection, problems with how the implant connects to the bone, or the mechanism of the implant are all possible symptoms of early post-operative pain. It is possible to have successful knee replacement surgery if the problem is resolved. In the unlikely event that the pain persists, additional evaluation may be required.
Staying In Shape Two Years After Knee Surgery
Frequent walks, hikes, and exercise on my local 9-hole golf course are a part of my weekly routine. Im playing pickleball twice a week.
I find that if I take at least 20 minutes to stretch I perform better and have fewer aches and pains after activity .
I make a point to stretch every day. I am not very flexible but I have seen some improvement.
My daily stretching and strengthening include calf raises, wall squats, and leg rolls with an exercise ball.
Bike rides every other day, on mostly flat roads, strengthen my legs and help me maintain and improve my range of motion. Along with swimming , cycling is a low-impact exercise that I cant recommend enough.
I have tried Yoga and I know it would be beneficial, but I am uncomfortable on my knees and am not able to do a lot of the positions.
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How To Diagnose An Infection
It may be evident to a surgeon that there is an infection in the knee with a simply visual inspection. There are tests that can be conducted to validate the presence of infection as you can see here:
- A Simple Blood Test: This can help measure inflammation in the body, which can indicate an infection.
- An Imaging Test: This can help determine if there is an infection in the artificial joint. Examples of imaging tests include X-rays, computed tomography scans, magnetic resonance imaging , or bone scans.
- Joint aspiration: Fluid is drawn from the knee and tested for bacteria and white blood cells. A large number of white blood cells is a sign the body is fighting an infection.
- Tissue Culture: The doctor may take a tissue sample from within the infected bone or joint. The doctor sends this specimen to a laboratory for examination.
- Bone Biopsy: Your doctor might perform a bone biopsy if he suspects that you have an infection that isnt showing up clearly on imaging tests. This process is similar to a tissue culture, in which a doctor uses a needle to remove a sample from the affected area.
For more on how to diagnose a knee infection click here: Diagnosing a Knee Infection
Richie got an infection in his knee during total knee replacement. He tells the full story in the video below.
Questions To Ask Before Surgery
The most important way to avoid infections and other complications is to “do your homework before selecting a surgeon and hospital,” says Lisa McGiffert, director of Consumer Reports’ Safe Patient Project, which works on helping patients avoid infections and other complications in hospitals.
Here are eight questions you should ask before you undergo your procedure.
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How Long Do Patients Stay In The Hospital
In general, the sooner you can leave, the better. “The typical length of stay is two days, then sending patients to a rehab center for days or even weeks, but the longer you are in a hospital-like setting, the greater your risk of getting an infection, especially an antibiotic-resistant infection,” says Grady-Benson. Ideally, you should be discharged to your home within two days of the operation, he says.
What Are The Alternatives To Revision Surgery
Alternatives to revision knee surgery are rarely used as they can sometimes be more complex and lead to worse results than revision surgery, but they include knee fusion or .
The following alternatives are employed depending on the seriousness of the problem affecting the knee:
- of the knee joint may relieve pain but at the expense of keeping the knee in a fixed, non-bending position.
- may be used in extreme cases in which the knee joint has a severe infection that cannot be eradicated
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Symptoms Of A Loose Knee Replacement
There are a few different symptoms that can indicate a loose knee replacement. These include: pain around the knee, especially when walking or bearing weight instability in the knee, which can cause the knee to give way a feeling of looseness in the knee and decreased range of motion. In some cases, a loose knee replacement can also cause swelling and warmth around the joint. If you experience any of these symptoms, itâs important to see your doctor to determine if your knee replacement is loose.
One of the most common complications of total knee replacement surgery is looseness. Excessive wear, infection, fractures, misalignment, and technical failures are the six most common causes of a knee replacement becoming loose. What are common symptoms of a loose knee replacement? misaligned knees are common symptoms of knee arthritis. The knee replacement may become loose in some cases if the prosthesis is not inserted properly or the cement is insufficient. Some people who have had knee replacement are allergic to the glue or the actual knee prosthesis. Redness, swelling, and loss of range of motion are all possible side effects of this condition.
Knee Replacement Pain: The Week Following Surgery
You should expect to stay in the hospital for several days following knee replacement surgery. This is often considered the most painful stage of the recovery process. Your doctor will prescribe medications to help you manage your pain level.
In addition to icing your knee, you may be encouraged to move your foot and ankle to increase blood flow and lower the risk of swelling and blood clots. Your doctor may also use blood thinners, support hose, and compression boots to prevent further complications.
Generally the day after surgery, a physical therapist will show you exercises that will help you recover your range of motion and continue to heal. You may even be asked to get up and take a few steps . Patients who get up and put a safe amount of weight on their new knee typically experience a quicker recovery.
After leaving the hospital, most patients continue to take some form of pain medication for two to six weeks. Your doctor will determine the best method of pain relief for your specific needs, whether it is over-the-counter medications or something stronger.
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Two Years After Knee Replacement
Time seems to fly by as we age. I cant believe its been two years after knee replacement.
One notable exception was the slow pace of recovery and rehab immediately after my knee surgery.
Now time seems to be zipping by. I remain busy with physical activity and I continue to do my physical therapy exercises for my knee.
After two years, my knee feels strong and Ive had few setbacks during the two years. Dont get me wrong, the first year wasnt easy.
Ive been vigilant stretching and strengthening my knee and each day I pay close attention to my overall health and fitness.
I have had to adjust my fitness routine during the uncertain times of the Corona Virus, but Ive been able to work out at home without issues.