I know what you’re thinking.
“No no no, that’s teeth surely? He means teeth doesn’t he? Yes it’s got to be teeth. Poor old thing’s gone a bit dotty. We should have seen it coming really, after all he’s been behaving a bit oddly for a while now. I expect it’s the rum truffles that finally tipped him over the edge….” and so forth.
But no. I do mean knees, or perhaps knee to be more exact, and prosthetic knee at that.
Allow me to explain.
A couple of days ago I saw a chap who had had a boiled sweet over the Christmas festivities. Hardly something to reproach him for you might think. And normally you would be quite right. But on this occasion things went rapidly “pear-shaped” as they say*.
You see the sweet in question shattered, lacerating his gum in several places. He gave the initial, albeit far from transient, pain little thought. However, by the next day he was beginning to feel a bit hot and a bit poorly. After a couple of days in bed with “the flu” the pain and heat settled in his knee replacement which remained hot and very very tender the day I saw him.
Now as anyone with any implanted prosthesis will tell you, they are all given a dire warning to watch out for gum injury during dentistry by seeking antibiotic cover. The thing is, even fairly minor gum injury, such as can be occasioned by the humble scale and polish, can introduce showers of bugs into the blood stream. From here the bugs can hop a ride like so many tourists on the underground, to any part of the body. They especially like prosthetics as they lack the normal defences of organic tissues.
So this poor lad appears to have a septic arthritis in his knee replacement and all for the sake of a boiled sweet.
I’ve told him to stick to chocolate in future. After all it’s kinder to the gums.
* In the absence of information to the contrary I am assuming the offending confection was a Pear Drop.
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6 comments:
Blimey, poor chap. No one ever told my mum that when she had her new hip.
Mind you, she didn't eat sweets.
Sounds like a good argument for avoiding those replacement joints.
That was remarkably unfortunate. Such a small, blithe action that required little thought - such disproportionate consequences.
Pear drop, eh? Who would have thought that they would be so vicious - butterscotch or blackcurrant and liquorice or the other hand...
Regards - Shinga
Dear clinician,
I am fascinated by this correlation between Pear Drops and septic arthritis. I am currently completing a study into the dangers of Pear Drops and possoble exaccerbation of COPD. Could I perhaps use your article as a point of reference?
Your fellow Pear Drop despiser,
Prof Scrub
http://www.scrubbingup.com/blogs/profscrub/blog.asp
Dr J - I've tagged you - I hope that's ok! :)
http://vilest.wordpress.com/2007/01/08/five/
z-- might be worth he checking with her dentist before she gets work done (assuming she is still in possession of some at least of her own toothypegs that is).
stitchwort-- well maybe, but give the improvement in his mobility and confidence this past 12 months, maybe not.
shinga-- indeed. the whole piece has something of the "for want of a nail..." about it.
prof-- fascinated to hear about the COPD work and would be interested to see the outcome. Happy to be a reference point with the caveat that thi s"causal" link is purely anecdotal and totally lacking in intellectual rigour, much like the rest of my carreer really ;-)
sooz-- eek. I'm assuming this means I get to do the same list as a post now? I'll give it some thought.
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