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Hip and knee replacement in lower limb amputees: a scoping review
Thomas J Walton1,2, Abigail L D Chatterton3, Victoria A Goodwin4
1NIHR Academic Clinical Fellow - Trauma and Orthopaedic Surgery, University of Exeter, St Lukes Campus, Magdalen Road, Exeter, Devon, EX1 2LU, UK. T.Walton@exeter.ac.uk.
BMC Musculoskeletal Disorders
|March 28, 2024
Summary
Lower limb amputees undergoing hip or knee replacement may have good outcomes, but more research is needed. Comparative studies are essential to understand amputee outcomes and complication risks after joint replacement surgery.
Area of Science:
- Orthopedic surgery
- Biomedical engineering
- Rehabilitation medicine
Background:
- Lower limb amputation alters gait biomechanics, potentially increasing osteoarthritis (OA) risk.
- Joint replacement is a common treatment for severe OA, but outcomes in amputees are unclear.
- Technical challenges exist for hip or knee replacement in lower limb amputees.
Purpose of the Study:
- To identify and summarize the existing evidence on hip or knee replacement in lower limb amputees.
- To assess the outcomes and complication profiles of joint replacement in amputees compared to non-amputees.
- To highlight technical challenges in joint replacement surgery for lower limb amputees.
Main Methods:
- Systematic scoping review following PRISMA guidelines.
- Searched MEDLINE (PubMed), Cochrane Library, EMBASE, and CINAHL up to April 1, 2023.
- Included all peer-reviewed literature on hip or knee replacement in lower limb amputees.
Main Results:
- 40 studies (265 patients) were included, primarily case reports/series with low evidence levels.
- Most common amputation reason: trauma (34.2%); most common joint replacement indication: OA (77.1%).
- Outcomes varied, but most studies suggested good post-operative functional status; technical tips focused on intra-operative residual limb control.
Conclusions:
- More observational studies are needed to define the link between amputation and the need for joint replacement.
- Comparative studies are required to determine if amputees achieve similar functional outcomes and if they face higher complication risks.
- Further research should address the specific challenges and outcomes of joint replacement in the amputee population.
