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I LIVE IN NAIROBI, KENYA. I HAD A TOTAL KNEE

Posted on Thu, 7 Mar 2019

Question: I LIVE IN NAIROBI, KENYA. I HAD A TOTAL KNEE REPACEMENT IN 2017 AND SINCE THEN I HAVE BEEN SUFFERING BECAUSE OF THE BACTERIAL INFECTION. ON 2ND MAY,2017 I WAS DIAGNOSED TO HAVE GRAM STAIN - STAPYLOCOCCUS EPIDERMIDIS AND THEN I WAS PUT ON PRITINAMYCIN ONE GRAM TO BE TAKEN TWICE A DAY. I HAVE BEEN TAKING THIS MEDICINE FOR THE LAST 22 MONTHS REGULARLY AND I STILL HAVE PAIN IN THE OPERATED KNEE. I AM ABLE TO WALK WITH THE HELP OF CRUTCHES. IS THERE ANY ALTERNATIVE TREATMENT TO GET OF MY PAIN AND WALK NORMALLY. PLEASE ADVISE. THANKS, L.V.GOHIL

Answered by Dr. Dr. Praveen Tayal (1 hour later)

Brief Answer:
Detail Below .

Detailed Answer:
Hello,
Thanks for posting your query.
A knee replacement infection may develop in the wound after surgery. It may also occur around the artificial implant that is used to replace the knee joint. Harmful bacteria entering the wound usually cause the infection.

A knee replacement infection can occur any time after surgery. For example, during the hospital stay after surgery, when a person goes home after surgery
Inability to walk without pain after the point at which the doctor said walking should be pain-free Indicate infection .
In your case infection goes deeper than the skin and tissue around a joint, it may need to be treated surgically.
Different surgical options are -

Removal of the artificial joint: When the infection is deep and long-lasting, the artificial joint will need to be removed.
Joint washout: Washing helps get rid of infected soft tissue in the joint.
Placement of antibiotic spacer: This helps maintain joint space and keeps the joint aligned while the infection is treated.
IV antibiotics: These help kill the infection. The doctor may prescribe a course that lasts up to 6 weeks.
New knee replacement surgery: Once the infection has been treated, another knee replacement surgery can be carried out. The doctor will remove the antibiotic spacer and give the person a new artificial knee joint.

I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal
Wishing you good health.
Regards.
Dr. Praveen Tayal.

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Dr. Praveen Tayal (23 hours later)

THANKS. I HAVE TO INFORM YOU THAT AFTER HAVING THREE TOTAL KNEE REPLACEMENTS IT IS NOT ADVISABLE TO HAVE A FORTH ONE.
I WOULD LIKE TO KNOW MORE ABOUT JOINT WASH OUT PROCEDURE WHICH CAN BE DONE IN NAIROBI. ALSO HOW DOES THE ANTIBIOTIC SPACER WORK. MAY BE THIS IS THE ANSWER. CAN THE MEDICINE PRISTINAMYCIN I TAKE BE REPLACED WITH ANOTHER MODERN DRUG.

REGARDS, GOHIL

Answered by Dr. Dr. Praveen Tayal (4 hours later)

Brief Answer:
Your orthopedician can decide after proper examination.

Detailed Answer:
Hello,
Thanks for posting your query.
A fourth knee replacement is not advisable. The joint wash and antibiotic spacer depends on your orthopedic surgeon and the physical condition. You can discuss regarding these options with your treating orthopedician who can choose the procedure which is best for you. The antibiotic that is best for you can be chosen after a culture sensitivity of the fluid.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal
Wishing you good health.
Regards.
Dr. Praveen Tayal.

Note: For further queries related to kidney problems Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar