Dear Dr. Roach: This year, I had a partial knee replacement on my right knee. Everything went fine; I have full mobility and I am almost pain-free. However, my right knee is warm to the touch, so I went to the doctor who did the surgery, and he said I have cellulitis and prescribed 10 days of antibiotics. After taking them, my knee was still warm, and he prescribed 10 more days of ciprofloxacin. It is still warm. He wants me to take 10 more days of ciprofloxacin. Shouldn’t this almost month of antibiotics have cured me by now? — W.B.

A: A partial knee replacement involves putting a prosthesis inside the joint, on one side. Anytime there is a foreign body in a joint, there is a risk of infection. The signs of infection include redness, warmth, swelling and pain, but they don’t all have to be present, and inflammation after surgery without infection sometimes can cause these symptoms.

Infection inside a knee can be very difficult to cure. Sometimes, the knee hardware has to be taken out completely and antibiotics given by vein for up to six weeks. I talked to a colleague who specializes in infectious disease, who was surprised by using the same antibiotic over again. I would recommend a consultation with an infectious disease specialist, who can provide better information on whether the knee could be infected.

Foamy urine and protein

Dear Dr. Roach: I look down in the toilet and see that my urine is white and foamy. What is this, what causes it, and is there anything I can do? — A.V.R.

A: Foamy urine raises concern of excess protein. High amounts of protein in the urine could result from nephrotic syndrome, an indication of a serious kidney condition. Any doctor can do a urine test for protein; if it’s positive, your doctor will have you collect all the urine you make in 24 hours to see how much protein there is.

Dr. Keith Roach writes for North America Syndicate. Send letters to Box 536475, Orlando, FL 32853-6475 or email ToYourGoodHealth@med.cornell.edu.

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