I've just seen this post, now being 10 days post op myself.
I had exactly the same and I'm a radiologist. One of my partners injected me in March this year and when the local wore off that evening I was in agony. After 24 hours I got some bloods done and the markers were in the suspicious for infection range so I had a CT guided aspiration. There were a couple of gram +ve intracellular cocci seen. This equates to possible infection but, equally, could have just been contamination. My colleague is very good at intra-articular work and experienced, I might add.
On the strength of the above I had 3 months (!) of antibiotics - the first month's worth being quite unpleasant. Gradually my markers came back to normal. However, even with raised white cell count, platelet response, CRP and viscosity (not sure what the American equivalents are), I strongly suspect that the cause of my pain was actually haemorrhage into the joint.
I was off work for 6 weeks and in severe pain. That pain abated to the extent that I could walk with a pronounced limp (being stupidly too vain to use a cane) and culminated in my having a resurfacing 10 days ago. But life was totally miserable in the interim. I couldn't really get out of the house, due to the pain, other than to work.
Just to complicate things, I was scheduled for surgery about 2 months ago, but got shingles a week before, so I elected to postpone it. The pain from the shingles was of no consequence compared with the hip pain.
As regards the swimming, incidentally, that was the only thing I could do to stay fit. I swam with what we call a pool-buoy in the UK, which is a polystyrene float you hold between your thighs and that worked a treat for me.
As regards potential surgery - have you had an MRI scan recently? If not, I would suggest you have one. It will give a good indication of whether you have infection present. Not foolproof but a very good indicator. It would be reassuring, of course, to see your vicosity return to normal but your other blood markers are also important. If it's only a raised viscosity and the others are normal and the mri doesn't show infection, that would all be pretty reassuring.
On the strength of possible previous infection, I elected for resurfacing on the grounds that to revise that is a whole lot easier than to revise a thr. It's crucial to have very good antibiotic cover. I had IV teicoplanin for 5 days and am now on oral fluclox for one month. They will need to take samples from the joint at operation to be sent to the path lab to check for any signs of infection. They do immediate microscopy then set up cultures to see if any bugs grow; that takes about 4-5 days to come back. Mine were both negative, so, so far so good. However, I remain gently anxious about it because if you've had infection previously you're slightly more likely to get it again. I still think mine was probably haemorrhage, or, as Pat points out, steroid flare, which is a well recognised, albeit relatively unusual complication.
It sounds as though you're very much in the same boat as I was.
I chose my surgeon with great care. Open to close time is about 40 minutes for her, which is fast. The longer they're inside you, the more the risk of infection, to some extent. Her results are fantastic. Also, the hospital I went to has gold standard nursing care. They've nursed cases with pre-existing mrsa but never had it spread.
I've now just seen your subsequent post, which I somehow missed before, saying you have avn as we call it. If the pathologist says that causes your viscosity to go up (I'm not sure of that but have no reason to doubt it) then it sounds as though you're home and dry re the infection side of things. But I'd still suggest an MRI because that shows avn pretty well. Surgery may need doing sooner rather than later now, though. If it's many months away and you're taking a lot of anti-inflammatory pain killers, make sure you get it xrayed from time to time as the meds may mask the pain of worsening avn. If the latter becomes too advanced, then resurfacing will cease to be an option.
Good luck with everything. If you're into iron man competitions then surgery will probably be a breeze for you, if it comes to it.
Andy
Topic: Pre-Op Infection (Read 2008 times)
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