Why Do Knee Replacement Infections Occur
Knee replacements can become infected as a result of the initial surgical procedure, other infections in the body, or often for unknown reasons. We do know that some patients are more prone to developing infections of their knee replacement. Risks of developing an infection include:
- Diabetes
- Rheumatoid Arthritis
Arthritis Patients: Get Your Flu Shots
As the COVID-19 pandemic continues, getting your flu and pneumonia vaccinations as well as your COVID-19 vaccination is vital to protecting your health.
Getting vaccinated against COVID-19 and its variants continues to be essential to protecting yourself and those around you. But just as important is getting vaccinated for influenza and making sure your pneumococcal vaccine is up to date especially for people with inflammatory forms of arthritis who take immune-suppressing medications.
According to the Centers for Disease Control and Prevention , the flu vaccines have been updated for 2021-2022 flu season to provide protection against four different flu viruses, also known as a quadrivalent influenza vaccine. Flu and COVID-19 vaccines can be received at the same time.
Autoimmune Risks
The flu is miserable and potentially dangerous for anyone, but its especially so for people with inflammatory arthritis. People with rheumatoid arthritis , lupus, psoriatic arthritis and other autoimmune diseases are at higher risk of flu, pneumonia and other infections. While the diseases themselves change how the immune system functions, many of the medications used to control the diseases suppress the immune system, making patients more vulnerable to infections.
Flu Vaccination
Early flu vaccination is also possible for women in the third trimester of pregnancy, because this can help protect their infants during the first months of life, when they are too young to be vaccinated.
Should The Flu Shot Be Given Before Surgery
The simple answer is yes, you should have the flu shot to prevent you from becoming ill before surgery. The flu vaccine and proper hand washing are the best ways to prevent the flu in all individuals six months of age or older. That said, when the flu shot should be timed prior to surgery seems to vary based on the opinion of the individual surgeon.
The Centers for Disease Control and Prevention recommends getting vaccinated in early fall. Getting vaccinated early, for example, in July or August, can be associated with reduced protection against flu infection later in the flu season, particularly among older adults. However, children who need two dosesshould start the vaccination process sooner, because the two doses must be given at least four weeks apart.
If the patient is taking the standard flu shot it should be received no less than one week prior to surgery. Some surgeons say one week prior, while others say two weeks before surgery at the minimum. If the live attenuated version of the flu vaccine is used the vaccine should be taken no less than two weeks prior to surgery, and some prefer it be given sooner than that.
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Timing Your Flu And Covid Shots
If you have not gotten your flu shot yet, the time is now. Even though flu season is already underway, the typical flu season lasts until May. Getting vaccinated now means you’ll be more protected for months to come.
If you are also eligible for a COVID-19 booster shot, you can get it at the same time you get your flu shot. There’s no need to space them out. Just don’t delay your flu shot if a COVID-19 booster isn’t recommended for you at this time.
Safe Sleeping Positions: Dos And Donts
Not being able to sleep in your go-to position can certainly keep you up at night. Unfortunately, when it comes to the safety of your new artificial implant, there are some positions that are off-limits. Its important that you stick to safe positions and pay attention to your body.
Around the 6 week mark, once your physician gives you the greenlight, you may be able to return to sleeping in your preferred position . Until then, stick to these positions.
Safe Hip Replacement Sleeping Positions:
Physicians Note: Sleep restrictions are tied to stability precautions. There are more sleep precautions for the posterior approach than the anterior approach. Ask your physician about positional precautions for sleeping to see if she/he have any for your joint replacement type. For instance, Dr. Tiberi adds that, The position recommendations are variable. Personally, I dont have any hip replacement position restrictions on sleep.
Note: It is not safe to sleep on your stomach after hip replacement surgery. Do not attempt to lie in this position. It is also unsafe to sleep on your surgical side. Consult your doctor to see if there are other positions you should avoid. After the 6 week mark, speak to your care team again to see if its safe for you to return to other sleeping positions.
Safe Knee Replacement Sleeping Positions:
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Risk Factors For Arthrofibrosis
The likelihood of developing arthrofibrosis increases with the severity of the trauma to the knee joint or the length of a surgery. The longer your knee is immobile, the greater your risk of having the condition. This is why its important to keep moving the knee.
If your surgeon gives you a diagnosis of arthrofibrosis, youll require additional treatment or possibly surgery:
Illness May Or May Not Delay Surgery
It would be wrong to assume that feeling unwell will lead to a canceled or rescheduled procedure. If your illness is related to your surgery, and the surgery can improve your condition, it is less likely that your procedure will be canceled.
It also depends on how long the condition typically takes to resolve. Strep throat, for example, is no longer contagious after 24 hours of antibiotics and might not delay surgery.
For example, if you are having severe chest pain due to a coronary artery problem, and you are scheduled for open-heart surgery to improve that condition, the procedure would likely go on as scheduled.
On the other hand, if you were scheduled for elective surgery and you were diagnosed with influenza the day prior to surgery, it is unlikely that you will have surgery as scheduled.
The nature of the surgery and the severity of the illness are often the deciding factors in whether or not surgery will be rescheduled. The final decision typically rests in the hands of the surgeon performing the surgery.
Illness such as a respiratory infection or stomach flu might delay surgery. But if your illness is related to the condition the surgery is aimed to improve, it might proceed.
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Risk Of Infection Associated With Preop Injections
Joint replacement surgery is a common treatment for severe arthritis of a joint. The most common type of joint replacement is knee replacement surgery, followed closely by hip replacement surgery. Generally, these surgical procedures are reserved for patients with severe arthritis who have failed extensive attempts at non-surgical treatments.
One of the more common non-surgical treatments used for people with arthritis is an injection into the joint. The most frequently used injections are steroids. One other type of injection is called viscosupplementation, an option for knee arthritis. Studies have examined whether these injections are safe to perform prior to planned joint replacement.
When Should You Not Get A Flu Shot
If you are currently experiencing flu-like symptoms including a fever, tell your healthcare provider before getting a flu shot. It may be recommended to wait until you are feeling better. People who have severe allergies to any vaccine ingredients should not get a flu shot. People with egg allergies should talk to their healthcare provider prior to getting the vaccine.
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The Latest Statistics Highlight The Importance Of Flu Prevention
The CDC classified 20172018 as a high-severity flu season with high levels of outpatient and emergency room visits for flu-like illness, as well as high hospitalization rates for the flu and widespread flu activity across the United States for an extended period. Since 2010, in the United States, the CDC estimates that the flu caused between 140,000 and 710,000 hospitalizations and between 12,000 and 56,000 deaths each year. For the 2019-20 flu season, the overall cumulative end-of-season hospitalization rate was 66.2 per 100,000, according to the CDC.
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Historically, each year the CDC has generated estimates of the number of illnesses, medical visits, hospitalizations and deaths that happen during a flu season . To produce these estimates, CDC uses a mathematical model based partly on the number of people that are hospitalized with flu in their hospitalization surveillance network.
During the 2020-2021 season, though, because we are in the midst of the COVID-19 pandemic, the flu season was atypical. The low numbers of people hospitalized with influenza was too low to yield stable burden estimates. Despite that fact, flu prevention and flu vaccination is as essential as ever especially for those in high-risk groups.
Does My Insurance Cover The Flu Vaccine
Most insurance plans, including Medicaid and Medicare part B, cover the cost of the flu vaccine for adults. If you do not have insurance, you may still be able to get the flu vaccine at no cost. Talk to your local health department for more information. Children aged 18 and under in Washington can get a flu vaccine and other recommended vaccines at no cost. The provider may charge an administration fee to give the vaccine. You can ask them to waive this fee if you cannot afford it.
For more information, visit www.KnockOutFlu.org.
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Common Questions About Flu Vaccination From People With Rheumatic Disease
Whatever people felt about getting a flu vaccine before the COVID-19 pandemic, it became even more confusing since. It became quickly apparent that people had questions:
The answer is Yes to all five questions. The existence of COVID-19 does not negate or interfere with usual precautions or measures taken to prevent the flu.
What Is The Influenza Prevention Policy
B.C. has an Influenza Prevention Policy to protect high risk people from influenza. Health care workers are required to be immunized against influenza or wear a mask when they are in patient care areas during the influenza season. Students, volunteers and visitors to health care facilities and other patient care locations are also expected to wear a mask if they did not get an influenza vaccine.
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Its A Myth That People Taking Biologics Or Dmards For Ra Cant Get A Flu Shot
It is true that people with RA who are treated with biologics or disease-modifying anti-rheumatic drugs cannot get a live flu vaccine, but they can be given an inactivated or dead flu vaccine. A common misconception about flu shots given to those treated with biologic drugs or DMARDs is that the immunosuppressant drugs render the flu vaccine ineffective. Not true.
In fact, according to research published in the journal Current Rheumatology Reports, people with RA who are treated with methotrexate or TNF inhibitors such as Enbrel , Remicade , Humira have an acceptable response to the flu vaccine, although it is a lower response than what is achievable by healthy people. Treatment with Actemra also is associated with an adequate response to flu vaccine. A reduced response to the flu vaccine was attributed to treatment with Orencia and a severely reduced response to the flu vaccine was linked to treatment with Rituxan .
Keep in mind, a lower response than is achievable by healthy people is not synonymous with an inadequate response or no response. There is still a protective effect which makes it essential for flu prevention.
Can I Get The Flu From Getting This Vaccine
A common misconception about this shot, is that you can get the ill from it. The truth is that this vaccine contains low levels of the debilitated Influenza virus, therefore, it cannot cause a real flu infection. On the contrary, this vaccine fosters the growth of antibodies that protect your body from this disease. With that said, it is true that some people experience mild symptoms and discomfort after getting this vaccine. Common symptoms after getting the flu shot include fever and body aches. However, this mild discomfort disappears after one or two days.
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Five Myths About Flu Shots
Understanding the truth about the flu vaccine will help you make the best decisions for your health.
Resident, Baylor College of MedicineThe Childrens Hospital of San Antonio
Ruchi Kaushik, MD, MPHAssistant Professor, Pediatrics, Baylor College of MedicineMedical Director, ComP-CaN Medical Director, Childrens Hospital of San Antonio Blog
Winter is here and with it comes the beginning of flu season. Every fall people across the U.S. hear the same thing, Its flu season get your vaccine, and despite health care providers recommendations, every year there are people who opt out. My intent is to bust the most common myths about the flu vaccine so more people know the truth based on evidence-based research. Here we go!
Myth #1: The flu vaccine gives you the flu. This is probably the biggest of them all. The flu vaccine does not give you the flu. Because the flu vaccine is made of a killed or inactive flu virus, it cannot cause infection. If you get sick after the flu vaccine, it is either your bodys immune response to the vaccine or symptoms of another virus .
Myth #3: I can deal with the flu it is just a bad cold.Some of the symptoms of the flu and a cold are the same, however, every year there are many people hospitalized and even deaths that occur due to the flu. In the U.S., an estimated 36,000 deaths occur yearly with more than 200,000 hospitalizations. Classic flu symptoms include fever up to 104 degrees for five to seven days, runny nose, cough, and body aches .
Steroid Injections Too Soon Before Joint Replacement May Increase Infection Risk
- Date:
- American Academy of Orthopaedic Surgeons
- Summary:
- Injections received in the months prior to total knee or total hip replacement surgery may increase the risk for infection and related complications, according to two new studies — among the largest conducted on this topic.
Injections received in the months prior to total knee or total hip replacement surgery may increase the risk for infection and related complications, according to two studies–among the largest conducted on this topic–presented at the 2016 Annual Meeting of the American Academy of Orthopaedic Surgeons .
Hip and knee injections frequently are prescribed to alleviate pain and inflammation in patients with osteoarthritis. Most injections contain corticosteroids to suppress pain and inflammation, but these drugs also suppress the body’s immune system. Patients with suppressed immune systems have higher risks of severe, post-operative infections that are difficult to control, and can result in additional surgery, prolonged antibiotic use, and even death.
In “Preoperative Hip Injections Increase the Rate of Periprosthetic Infection after Total Hip Arthroplasty,” researchers reviewed data from 177,762 patients in the Statewide Ambulatory Surgery and Inpatient Database, for Florida and California, from 2005 to 2012.
Of the patients in this study, 29,603 had an injection at least one year prior to TKR and 54,081 did not.
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Treatment Of Knee Replacement Infections
Knee replacement infections are usually separated into categories of early versus late infections. Early infections occur within weeks or months of the surgery and are often treated with surgery to clean the infection, followed targeted to the specific bacteria that is causing the infection. Multiple surgical procedures may be necessary, and antibiotics are usually continued for a minimum of 6 weeks.
Late infections are more difficult to treat and have often been present for weeks, months, or even years before the diagnosis of infection is made. The knee replacement implants may become loose if the infection has been present for a long time. In these cases, the implants often need to be removed and the infection treated. Most often, the infected knee replacement is removed, the infection is treated for a minimum of 6 weeks with antibiotics, and once the infection is cured, a new knee replacement is performed. This is a so-called two-stage revision knee replacement because two different surgeries are performed, one to remove the infected knee replacement, and another to put in a new knee replacement. In some cases, a one-stage revision, where the infected knee replacement is removed and a new one is put in during the same surgery can be performed. However, caution must be used, as if the infection is not adequately treated, then additional surgery will likely be necessary.
What Is The Long
Although its a rare condition, its important to be on alert for arthrofibrosis. Those who have it are likely to have difficulty recovering and returning to a more active lifestyle. Monitor your range of motion throughout your recovery and talk to your doctor if you notice stiffness or any decline in the function of your artificial joint.
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