Joe A Shaw PA-C - 1/24/2008

Question
Dr, My wife was diagnosed with MRSA and has also total knee replacement on both knees. The knees are very warm and has also a slight temp. After given her techoplanin,doxysyclin and chlorofenicol, her knees remained swollen.The orthopedic doctor suggest to take the prostheses out(of both knees) leave them out for six months and put them back again. Can she recover from MRSA? Thank you Albert Attard-Santa Venera MALTA

Answer
Albert,
I'm sorry you and your wife are having to go through this. There is hope that she can beat MRSA. It sounds like they want to do a 2 stage revision, where they take out prosthesis, debride as much as they can, put in spacers and treat heavily with antibiotics etc..then put in new prosthetics. This method of removing the prosthetic of infected joints can certainly take a toll on the person, but sometimes it's the only alternative. There seems to be no real consensus as to how long the prosthetics should be left out, it just depends on the individual case and ortho opinion. There is a one stage revision, but this seems to be used mainly with hips. I would seek out a 2nd ortho opinion for sure. (As my profile says I am not an MD, rather a PA, but I think you will find my advice valuable) I also have included one of the best articles I have read one the subject. Although it is from a medical journal I think you can understand most of the article.

http://jac.oxfordjournals.org/cgi/content/full/53/2/127

Kind regards
J.Shaw PA-C