Knee Replacement Problems

I am a 56 yr old male who had total right knee replacement 4 yrs ago yesterday, 28May2008, and since I have had many problems. Now, I did have torn cartilage surgery Aug1972 in the right knee. Two weeks after knee replacement I started therapy, and the first day the guy put me into a sit down cpm with the setting at 80% saying we have to get results immediately, that's what the doctor ordered. That was terribly painful. It took me many sessions to get him to back off on the setting, and I was slowly progressing. At home I had a portable cpm for use and over a 2-3 hr time could get up to 100%. My knee remained swollen and blood tests indicated an infection, besides tracking my low platelet count problems (last one last week was 33). August 2008 the knee was scoped, scare tissue remove, and the leg "bloodily manipulated" as the doctor put it. I was both losing movement, more pain, and y left would swell 8-10 inches bigger than my left. 10Nov08 I was struck by a pickup in an ally way at low speed, just knocking me down and to the side. The leg did not hurt. From then on I have had Bone Density and CT scans, White Cell Tagging, and they can't find the infection. In December 2008 the knee quit working altogether ending up straight and swollen. $ yrs later I have just finished 6 weeks of zyvanz and daptomycin antibiotics through a PICC line and still have an infection according to the CBC on 22May12. Also I had a nickel size blister come up in July and December 2011 that when opened up oozed a greenish gray puss like fluid that cultured out to be sterile, their thinking was a dissoluble stitch that was left behind. It has not come back since. Pain meds currently are Hydrocodine 7.5mg 3x daily, morphine time released 60mg in morning and 30mg at night, Gabapentin 800mg 3x daily and antibiotic Bactrimm DS 800mg 2x daily.

Do I have a defective knee, am I rejecting the knee or what? I am disabled and am tired of the pain and missery that goes along with this. Oh, and my surgeon really does not want me back in his office, looks bad for business I guess.    

[S. Kaul, MD]

Hi there!

Well, without knowing the relevant clinical details, it would be difficult to comment on the situation. With organisms that do not easily grow on culture media could also cause a sterile culture despite the infection when blood tests for infection would be positive. Aside infection, there could be a number of other factors that could cause instability of the replaced joint such as bone weakness, fractures/ injuries etc. I would suggest seeking a review with your treating orthopedician or considering a second opinion with another orthopedician for suggestion of an appropriate management plan.
Hope this is helpful.

Take care!