A hidden infection, a complex surgical journey and the care that helped one patient reclaim his life
“Dr. Wolfstadt saved my life.”
Issa Abdalla knows that if the infection that developed after his revision knee surgery had gone undetected, he could have lost his leg—or worse. That’s why he’s so thankful to Dr. Jesse Wolfstadt, Head of the Granovsky Gluskin Division of Orthopaedics at Sinai Health, and the orthopaedic team at Mount Sinai Hospital.
“I’ve met a lot of doctors in my life,” says Issa, “but no one ever listened to me the way he did. He always kept telling me, ‘We’ll beat this together.’”
Sinai Health’s Orthopaedic team delivers some of the most complex reconstructive orthopaedic care in Canada, with a specialized focus on complex hip and knee replacement and revision surgeries. Revision procedures are required when a joint replacement fails or complications develop, and they demand a high level of expertise. Each year, Dr. Wolfstadt and his team perform approximately 180 revision hip surgeries and 150 revision knee surgeries—more than all the other academic hospitals in the Greater Toronto Area combined.
This depth of experience proved critical in Issa’s case. After having both knees replaced several years earlier at an outside care facility, he underwent two revision surgeries to address loosening implants. While the first revision was a success, the second left his left knee swollen and painful, making it difficult for him to bear any weight on it. Despite rehabilitation and pain management, his symptoms persisted.
Initially, Issa was told that the pain he was experiencing was an expected part of the recovery process. But eventually, after refusing to give up, Issa was referred to Dr. Wolfstadt, who took his pain seriously and was determined to help him find the source.
“I couldn’t shake the feeling that something was wrong.”
“Issa didn’t present as an infection that was easy to diagnose,” says Dr. Wolfstadt. “But, when we sent for some of the more high-level, next-generation sequencing, that’s when it was finally revealed that Issa had an infection in the knee. That was most certainly what was causing his pain all along.”
Patients who have experienced revision surgery are at a higher risk of developing periprosthetic joint infection (PJI), a deep infection within the replaced joint. These kinds of infections can be physically, mentally and emotionally devastating because they require painful, prolonged treatment and repeated surgeries that limit mobility and independence.
Once the infection was confirmed, the orthopaedic team leaped into action. Issa underwent a two-stage revision procedure. First, the team removed the affected implant, replaced it with a temporary one and administered high doses of antibiotics. Then, after a six-week course of intravenous antibiotics and careful monitoring, a second surgery to put in a new joint replacement was performed.
Issa recalls waking up from that surgery and immediately feeling awash with relief. The pain was finally gone.
“Now, I feel great,” says Issa. “I’m walking everywhere, I’m able to do my training at the gym. Without Jesse, I wouldn’t be doing what I’m doing today.”
None of the boundary-pushing surgical care offered by Sinai Health’s orthopaedic team would be possible without the support of our generous community. As the Granovsky Gluskin Chair in Complex Orthopaedic Reconstruction, Dr. Wolfstadt is contributing to global research aimed at reducing infection rates and improving outcomes for patients like Issa with PJI. He is also leading research focused on integrating mental health and multidisciplinary supports into recovery, recognizing the emotional toll of prolonged and complex surgical journeys.
“There’s a high rate of undiagnosed depression and anxiety in many of these patients,” says Dr. Wolfstadt. “They’ve had a joint replacement thinking they’re going to get their life back and now they’re going through this long, onerous recovery. Recognizing the mental health aspect and understanding how much of a burden this has on patients will help us take a more multidisciplinary approach to the management of their care.”
