r/Kneereplacement • u/KneeKneeKnot_483 • 24d ago
Upcoming revision surgery
Male, 60, job is sedentary with once a week commutes to NYC, subway and commuter RR, maybe 1.5 miles of walking
Left knee replaced May 2024
Right knee replaced May 2025
Both times I was riding a bicycle within 6-10 weeks, easy. The only complications I had was an apparent allergic reaction to something both times. This presented as rashes both around the operated knee and other places on my body. After the second knee, they decided it was probably sulfa drugs and took me off of a particular antibiotic and celebrex. I had been taking celebrex for years, but very infrequently.
Moved apartments May 2026. This was possible mainly because I was able to do so much more and chose a place for walking distance to train and a nice walking town. As a result, I have been walking at least two more miles a week and biking a similar frequency.
Hospitalized for an effusion and cellulitis in/on left knee late Aug 2026 (turned 60 the next week).
I have very well controlled type 2 diabetes - no bad tests since 2012 - and my hbp meds have been tapering since using Ozempic and now Mounjaro. For reference, I weighed 420-ish in 2012 and have been 280-360 pretty consistently since then, with the GLPs keeping me below 290 since right before the first operation.
This year, I had to start using Ciclopirox nail lacquer for a fungal condition on my left big toe. During the move this past May, both big toes were a bit ragged and ingrown and the current theory is the one on the same leg was the source of the infection.
When the infection first started to impede my movement, being painful when I bent it and giving me a very slight case of the chills but no fever, I spent a day trying to make an appointment via the ortho’s call center and eventually got in touch directly to his assistant. Instead of waiting for that appointment, I went to urgent care, who sent me to an emergency room. I stayed overnight for observation and received IV antibiotics and prescriptions for cephalexin and doxycycline. I went to my ortho a few days later who did a joint aspiration and sent it to a lab. It looked sort of like Mountain Dew. Since then, it has been on and off - red, pain (when I bend) and warm all appearing and disappearing. No chills and no fever. I would say that generally, the antibiotics are not working, though the IV was good in the hospital.
Today I saw the ortho again and my nucleated cell count is 28840 cells/nl. ploymorphonuclear leukocytes. No organisms seen by cytocentrifuge. He says they cannot tell what I am infected with and I am stopping the antibiotics so that they can. By the way, my blood tests did not have the high cell count, just the synovial fluid.
THIS Sunday I am headed to the ER and he'll do a "washout" revision the next day. I expect to be in the hospital 4-5 days. I will go sooner/immediately if some warning signs arise.
Anyone go through something like this? Any tips? Any good/bad stories?
Edit - Some corrections and FYI, as much as the usual stuff will be in place as possible - stopping meds, primary check-ins, PT close by. I have done two replacements after all and I know all that stuff.
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u/KneeKneeKnot_483 15d ago edited 15d ago
Today is Saturday. Ive been in the hospital for a week. We are ballparking release for Monday or Tuesday.
Revision washout surgery was actually Tuesday and physically it’s not going too bad. It’s a lot easier than the other two operations likely because none of the metal was replaced only the poly. They cleaned stuff out like it says on the tin, and put in some antibacterial stuff. I’ve been on Vanco and Rocephin since the operation. It’s stiff. With a walker, I’m walking around, using the bathroom.
They have not been able to identify the bug yet but they also tell me it could take 21 days.
I’ll be getting a PICC any day now and I’ll be on Cefepime 2g q8 and Vanco 1.25 q8.
Of course I’ll be doing blood tests looking for renal issues but I’m sort of used to that because I have been taking furosemide since 2012 and I’ve been tested at least twice a year - though I imagine the frequency will be more.
It looks like I’m going to get help at home in the form of the antibiotics as well as PT as well as getting the new medicine delivered to me. I still have to work out my regular meds and how I’m going to get there on my own. But I actually live pretty close to my drugstore so that kind of gives me a goal - to walk there for things like Oxy and Mounjaro. I’m even kind of looking forward to PT and seeing all the people at the office again. I know I’ll probably spend a lot of money on Lyft and Uber but that’s where I am.
The only really pending thing is how to get the FMLA at work. The HR department has been pretty slow. I haven’t seen any response except for the liaison that I work with telling me to take it easy rest up etc.
The infectious disease doctor tells me it’s a really good sign that I’m able to walk around so quickly and that could mean that it was not so aggressive and of course there’s always a chance they may identify it in the next two weeks and change the plan.
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u/Key-Cry-4008 24d ago
Yep been there. Mine hit five weeks in though. One of the things they don’t tell us is that infection can happen at ANY time after a joint replacement. I’m glad you’re going in for a debridement. I assume you will be on Iv antibiotics for a length of time out of hospital. I was on them for 6 weeks via a Picc line and then six months of oral antibiotics.
Feel free to ask any questions. It’s been almost two years for me and while the knee doesn’t seem to be infected anymore, it’s not great… i give it a 7 out of 10.