DEAR DR. GOTT: I enjoy reading your column. I have a question for you. I had a total knee replacement in December 2010. I developed a staph infection in my knee, and the surgeon also found a blood clot in the calf of my leg. I have heard different remarks about the clot and how long it will affect me. I am still having pain in my calf, and it does not ease up. How long will the blood clot cause me pain in my leg? I have a hard time doing my therapy because of it.
DEAR READER: Based on your brief note, I have more questions than I do answers. First, what medications are you taking? I am assuming that you’re on an anticoagulant to help prevent the clot from traveling or worsening, or others from forming; an antibiotic to combat the staph infection; and likely, a pain medication, either over-the-counter or prescription. Do you have any other health conditions? Are you male or female? What is your age and general health status?
Without knowing the answer to these questions, giving you advice regarding a blood clot in your leg is difficult. For example, do the doctors believe the clot formed as a result of your knee replacement or was it there before your surgery? Do you have a family history of clotting disorders?
You should likely be on a thombolytic medication, which will help dissolve the clot, and an anticoagulant to prevent new ones from forming. But if you have a family history of clotting disorders, it may be beneficial for you to continue with the later medication for life; however, if the clot is from your knee-replacement surgery, you may be able to discontinue it safely a minimum of three months after the clot has dissolved.
The staph bacteria were likely introduced into the body at the surgical site. Staph is fairly common and treatable, but it may slow the healing process. A culture of the site should reveal which antibiotic will best eliminate the infection.
As for the pain, I cannot give you a clear answer. The clot may not be the only cause. You have had several complications from your knee replacement, which itself can cause pain post operatively for a time. I suggest that you make an appointment with your primary-care physician to discuss the situation and to express your concerns. You can even ask that he or she call your orthopedic surgeon so they can work together to help you recover quickly and safely.
Readers who are interested in learning related information can order my Health Report “An Informed Approach to Surgery” by sending a self-addressed stamped No. 10 envelope and a $2 check or money order to Dr. Peter Gott, P.O. Box 433, Lakeville, CT 06039. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com/order_form.pdf.