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What causes painful leg and high WBC count after hip replacement?

Answered by
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Dr. Mukesh Chugh

Orthopaedic Surgeon, Joint Replacement

Practicing since :1997

Answered : 1619 Questions

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Posted on Mon, 4 Aug 2014 in Bones, Muscles and Joints
Question: I had a hip replacement 2 mos ago got infected had home ivs 6 weeks now on pills at first my wbc when at home was 5.6 then 3 weeks it is 7.0 now it is 7.6 it is going up does that mean my infection is coming back I have been having burning pain last night was bad I was crying in my sleep its going down my leg and it also has the same feeling when I had the infection then today I was moving my leg and hip sideways and that is the way dr check to see if was infected taking my leg and moving sideways back and forth never hurt before now it does what do you think it means had xray show nothing but when I had infection first time they were good to so xrays don't show nothing thanks
doctor
Answered by Dr. Mukesh Chugh 3 hours later
Brief Answer:
CRP is the best indicator of Infection

Detailed Answer:
Hi
Thanks for posting
I have gone through your query carefully; the increasing level of WBC along with pain is suggestive of Infection. You need to visit your treating doctor for further advice. It takes long time (month's) for the x-ray to show sign of infection.
The two best indicator of infection are-
1. Pain on movement
2. Blood test-Raised and progressively increasing blood level of CRP that is C reactive protein.
You may take rest along with the prescribed doses of antibiotics and pain killer.
Hope this helps and I shall be glad to answer any further query.
Take care

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Mukesh Chugh 15 minutes later
the thing is my before my first surgery my leg hurt way more than hip dr called it radiating pain even when I got shots in my hip it would last for years or so I thought I was not feeling much pain in hip all leg and knee and pain has return there plus where incision is at it is like when they cut your leg off you still feel like it is there well I feel sometimes my infection is still there my crp was 7.27 a week ago when they tested my wbc I know that is high receive copy of my blood work and that what it say so what does this mean in total thanks
doctor
Answered by Dr. Mukesh Chugh 9 hours later
Brief Answer:
Blood work and symptom are suggestive of Infection

Detailed Answer:
Hello
It’s good to see you
After going through the whole discussion, it seems you have a flare up of infection as suggested by raised CRP, WBC and painful movement at hip. I would advise you to go for repeat CRP test as progressive rise of CRP is more informative regarding infection as compare to single CRP test.
You may visit the treating doctor and meanwhile continue with the treatment as discussed earlier.
Hope this information suffices and if you have further query please do not hesitate or you may close the present discussion.
Wishing you good health.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Mukesh Chugh 13 hours later
why would my dr say these test was good my gp dr is it cause she is used to seeing these numbers on me or what the my hip surgeon says not concern enough to send me to hospital now my infection dr said 5050 that he got it out blood work don't say whole story he seem concern that my hip dr did not take my stem out like infection could breed on that thanks
doctor
Answered by Dr. Mukesh Chugh 33 minutes later
Brief Answer:
Bone scans help to show disease activity

Detailed Answer:
Hello
There has to be a cause for pain on movement at hip along with moderately increasing WBC and CRP.The most likely reason for this seems to be Infection. The other test to show Inflammation/disease activity at hip is bone scan; this may be done after discussion with your doctor. Keeping in mind the dilemma you are going through, it’s my sincere advice to take a second opinion from another hip surgeon.

Take care and I hope you have found something useful.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Mukesh Chugh 19 hours later
the ortho dr did not take my stem out when he had to do revision sur which my other dr was concern about plus I lost my oral antibiotics so I was supposed to be on 2 mos I cant get refill till next month how important are those pills since I had 6 weeks iv thanks plus I have uti bladder cant see dr for 3 weeks cause she is on leave thanks
doctor
Answered by Dr. Mukesh Chugh 15 hours later
Brief Answer:
Must arrange and take the antibiotics course

Detailed Answer:
Hi
Are You planning for a revision hip surgery because of Infection?
As the revision surgery is the last resort in case of uncontrolled infection at operated hip.It is difficult and demanding surgery.You must take the perescribed course of antibiotics as it helps in infection control. Hence,it is sincere advise to have them.
Hope this helps.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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