Can a post-operative infection cause D-dimer levels not to improve after a knee replacement surgery?

Hello,

Welcome to icliniq.com.

I went through your query and understood your concern.

Let me explain to you about the D-dimer levels. Elevated plasma D-dimer indicates that coagulation has been activated, a fibrin clot has formed, and clot degradation by plasmin has occurred. There are many causes of elevated D-dimer; identifying the underlying cause requires correlation with other findings. I can mention here many causes of elevated plasma D-dimer levels, but that will not work and guide you specifically. However, I have a few questions,

1. What is the CBC (complete blood count) count?

2. Is there an increase in the WBC (white blood cell) count?

3. Is there any pain or pus oozing from the site of surgery?

4. Why would you say you never recovered?

5. Can you share your recent laboratory reports to correlate better?

6. What medications are you currently taking?

Please reply to the above questions to guide you further.

Take care.

Hi,

Welcome back to icliniq.com.

I do not understand what is vaccine injured as result of a blood transfusion. The numbness in your legs is suggestive of some peripheral neuropathy. An appropriate physical and clinical examination would be needed to identify the site of the lesion of neuropathy and, if possible, the cause of neuropathy. You had knee replacement surgery on your right knee, and currently, you have swelling in the right knee. It means some localized pathology is present in the right knee, and you need to undergo an imaging evaluation like an MRI (magnetic resonance imaging) knee to identify the cause of it. Your doubt is whether you have an infection at the operated site or not, leading to an increased D-dimer level.

If any localized infection is present, you would expect increased tenderness, local skin warmth, and restricted joint movement. If the above findings are present, there is likely infection, which can contribute to increased D-dimer level, but the possibility is least. Also, you have mentioned 2 MTHFR (methylenetetrahydrofolate reductase enzyme) genetic SNPs (single-nucleotide polymorphism). In such genetic inheritance, there is a slight increase in the levels of homocysteine present in the blood, and homocysteine can damage blood vessels and lead to blood clots. This could be another possible reason for elevated D-dimer for over a year. Also, I suggest you to do a laboratory test of LFT (liver function test) and KFT (kidney function test) as liver and kidney dysfunction can cause reduced clearance of fibrin degradation product. Also, redo the duplex ultrasonography for venous thrombosis.

I hope this helps.

Kindly follow up if you have any further queries.