Here is the latest report & some promising news about who is winning in the battle of "Peter vs. The Infection". We're happy to report that he is taking the LEAD in this race.

Dr. Soin indicated the infection, while certainly a significant problem, thankfully looked like he would expect it to (given he had a previous surgery for infection). There were no new signs of 'more infection' which he said was very positive. He also opened the area higher on the thigh and didn't see anything alarming or suspicious looking although there was one portion he sent out for a culture. Dr. Soin put two drains in the knee. One is behind the shin bone high in the tibia where the plate used to be and another one in the knee joint itself. He washed everything really well.

Prior to the surgery, the Doctor was concerned that the medial side of the knee had no muscle, tissue, ligaments, etc. to help heal the incision (he referred to it as a dam and without it sometimes it's hard to stop the draining for the wound to get better). If so, this would mean he would need another surgical team to take muscle from another area of the body (i.e., calf) and essentially build the 'dam' in his knee to avoid this. The good news is that after going in to check out the knee, the Doctor is more confident this will not be necessary (however it wasn't ruled out). Overall Dr. Soin thinks this has a chance to heal without the muscle flap but not certain. That's really good news.

He doesn't think he will need to wash it again it looks fairly clean. He will continue with the antibiotic IV and see how he does clinically. He was able to remove both of the two remaining screws behind the knee but didn't need to take the bone cement out. The cement did not seem compromised by the infection and it would have been very destructive and invasive to do this. We're grateful this wasn't necessary.  

The overall outcome is still (unfortunately) that his right knee is going to be a 'very stiff knee'. The Doctor understands we've gone through so much to make it more functional but at this point it is all about saving the leg from a very bad infection and he encourages us to realize and accept that. It is no longer about keeping the knee moving and gaining range of motion. In fact, aggressively moving the knee puts a lot of stress on the tissue so we need to keep this knee straight for at least 2 weeks then start doing minor motion. He warned these efforts may not work and he was candid Peter may not gain this motion due to his suspicion of it ending up a very stiff knee. 

When asked if it was too early to recommend a solution moving forward (for movement) it is too early to say what is best and we need to get over the hump of the infection. There isn't room to do anything anytime soon. Any sort of reconstructive effort will need to be after the infection is truly healed and he is off the IV antibiotics and essentially 'out of the woods' with no recurrence. This time frame is another 6-12 months out. 

We understand it's a long road, but one certainly worth traveling.