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Swelling And Inflammation From Surgical Site; Pain, Stiffness, Declining Mobility, Falls. What Tests Can Be Done?
Question: My father has been active throughout his life. His weight is unchanged (maybe less) than in high school. He was a PE teacher and coached high school football and track. After retirement he played handball and racquetball. A resident of Washingon State but longing for warmer weather he began spending the fall and winter months in Arizona. There he began playing tennis competitively.
He underwent TKA revision surgery in February 2011 at 85 years of age. On day 10 postop he had significant and spontaneous drainage from his surgical incision after the staples were removed. On day 17 postop his home health physical therapist referred him to his orthopedic physican's office due to swelling and inflammation along the surgical site. He was placed on antibiotics at that visit. No diagnostic tests were done. My father continued to decline. He experienced worsening pain, stiffness and declining mobility. He began to have falls. He rated his pain at an 8-9/10 (scale of 0 - 10). He said he doesn't know how much longer he can take this kind of pain.
His surgeon suggested he "suck it up" which he even documented in my father's medical record.
No diagnostic laboratory tests have been done to investigate his condition. What tests would be indicated under these circumstances.
He underwent TKA revision surgery in February 2011 at 85 years of age. On day 10 postop he had significant and spontaneous drainage from his surgical incision after the staples were removed. On day 17 postop his home health physical therapist referred him to his orthopedic physican's office due to swelling and inflammation along the surgical site. He was placed on antibiotics at that visit. No diagnostic tests were done. My father continued to decline. He experienced worsening pain, stiffness and declining mobility. He began to have falls. He rated his pain at an 8-9/10 (scale of 0 - 10). He said he doesn't know how much longer he can take this kind of pain.
His surgeon suggested he "suck it up" which he even documented in my father's medical record.
No diagnostic laboratory tests have been done to investigate his condition. What tests would be indicated under these circumstances.
Hello.
Thanks for posting your query.
I'm sorry to hear about your fathers condition, and to top it the uncooperative treatment given to you by your physician.
From what I gather, he must have had an infection of the operative site. In such cases, it is imperative to collect the discharged fluid or pus in a sterile container and send it for culture-sensitivity. The sutures need to be reopened and the joint needs to be debrided (thoroughly cleaned). A drain needs to be kept in situ for a few days till all the unwanted material is evacuated. Till then the reports of what organism has caused this and which antibiotic would work should arrive. If no organism is isolated from the sample, then his blood and urine samples also should be sent for investigation.
While he's at it, he may benefit from intravenous antiinflammatory drugs. He must begin physiotherapy again in form of continuous passive motion, so that he does not develop stiffness. In worst case scenario, he might require a 2 stage surgery for complete anti sepsis. 1st stage for removal of the metal implants and to put an antibiotic spacer, and 2nd stage for reimplantation with new implants. This is done over a period of 6-8 months. Lets not worry about that yet.
First thing is to establish the organism and treat it well, and fast.
Hope this answers your query. Shall you need more help, i'm available for follow up.
Regards.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Jyoti Patil
Answered by
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