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Sunday, January 5, 2014

Knee and Foot Surgery Questions: Email Advice

Dear Dr. Blake:

I have a too short first metatarsal on my right foot and walking on this too short metatarsal for over 7 years has also damaged my knee.

Questions for you:

If I have the knee surgery first, will I need to be on antibiotics the whole time that I recover from my foot surgery if there are pins sticking out of my 2nd and 3rd toes, since these need to be shortened too?   Does having a total knee replacement with a metal implant complicate in any way a future foot surgery on the  on the same leg?  Are most knees able to tolerate a Rollabout after knee surgery?
Many thanks for the information.  Your blog is great!

Dr Blake's Response:

Thanks for the questions and the compliment. Definitely you need the knee surgery first, since it changes how you walk and may change the foot correction given. Typically there is a 3, but preferrably 6 month wait between surgery. Yes, the knee must be able to take the stress placed by the Roll aBout, so it is the physical therapist more than anyone that says it is time for the foot surgery. You should have a month practicing on the Roll aBout with good success before you undergo surgery. You do not need more than a peri-operative antibiotic (at the time of the surgery) for the foot surgery in general. However, the orthopedist in charge of your knee health, may think otherwise. I would be surprised if you had more than a 2 week course of antibiotics with the foot surgery. Have the 2 doctors talk, or consult an infectitious disease specialist prior to the foot surgery to have them discuss things and come up with a plan. The bacteria is stirred up at the time of the surgery and the skin is typically completely healed at 2 weeks. Topical antibiotics are placed over the pin exit wounds. Hope this helps. Rich Blake

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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.