Just been told I have to have a double knee replacement but will not be able to restart Rituximab for 9 months. Also have MSSA.

[HarleySue]

I haven't been on this site for nearly a year now as after 4 cycles of Rituximab I thought I was starting to get to grips with how to cope with this awful RA. I went to the consultant last week to what I thought was a routine appointment and was told that the cartilage in both knees has been destroyed by RA and they need to replace both knees now. During pre op assessment they swabbed me for MSSA and I tested positive. Could be from infusion sights I was told but not to worry as nasal ointment will clear it up before ops. Please has anyone any experiences to share as all this has hapened so quickly and I have to have any questions ready for 5th March when I meet my team. What worries me most is not being able to return to biologic meds, Rituximab, for 9 months.

[earthwitch]

Many years ago I was infected with MRSA and had some nasty sores on my feet from it, where it had got into what had been a blister. I thought I'd got rid of it with a double dose of strong antibiotics, but hadn't, because some years later it surfaced again with massive crops of boils, including some really awful carbuncles. GP first of all just kept treating me with standard antibiotics, then I finally got a culture done to find out what antibiotics would work. Long story short, but it wasn't until I got both the right antibiotic tablets AND that nasal ointment, that it finally went away. I believe that MRSA kind of hangs out in your nose, so thats whey they treat with the nasal ointment. If you use it as directed, then it should finally deal with it properly. Can totally understand why they won't let you take your antitnf though - if you did get a flare up of the MRSA while on ritux. it could be really serious.

[Hidden]

No experience of MRSA although know it needs to be treated effectively.

I've had both knees replaced now, one 5 years a go & had the other one done this week - I'm just 60, mine fell apart from both RA but probably more OA.

Good luck - do you know when the surgery will be?

[Hidden]

I had MSSA bacteremia from a post op spinal infection and although I got through ok in the end, I wouldnt wish it on anyone. Some say its debatable that they help, but this study says its well worth using the ointment intra-nasally (plus the skin and hair washes 5 days before your op) which I didnt as I wasnt tested prior to having my surgery. According to this research, the infection rate fell dramatically by 82% after implementing the prophylactic (preventative) treatment:

( aaos.org/news/aaosnow/apr11... )

MSSA is positive in approx 20% of those tested and after the studies showed they were also as vulnerable as MRSA carriers to have serious post op infections, they decided both should take preventative precautions not just the MRSA pos ones.

So good luck with the op... I vaguely remember reading that its only 1 or 2% that have MSSA infections post arthroplasty ops - Im sure it will all go fine.

[trianon]

Amongst other replacement op's I also had both knees replaced in 1995 when I was 40. It is painful when you are first got out of bed and start mobilising - but NOWHERE near as bad as the pain prior to the op. I wouldn't hesitate to have it done again. Not had MRSA but did have infection after knee op though - blisters from neck to ankle, some huge that had to be drained, was wrapped in bandages, on huge doses of Piriton so was out of it for a week (but was still woken for exercises!) etc (never found out what infection was). But would still have op again! Good luck.

[HarleySue]

Thank you all for your replies and it sounds like what I've been told is correct. I need to do the special body washes twice a day and also to take special antibiotcs and nasal spray to clear the MSSA for 5 days prior to ops. I feel happier about it all now but won't get my hospital date until I've had the "team" meeting with the physios, OT's, doctors etc on March 5th. No doubt I'll have more questions then that I can ask for assurance on. Thank you everyone xx

[Hidden]

Hi was just checking out your thread again as I couldnt remember the date for your "team" apt. I am about to go back into hospital tomorrow for more spinal surgery so I was interested in what they had said about it.

But I see its on the 5th, the day of my surgery, so good luck with it, dont forget to ask as many questions as you need in order to feel comfortable about going ahead with the knee ops...

-gail