Through-Knee Amputation Following Total Knee Arthroplasty With Retention of Femoral Component: A Case Report

Extensor mechanism disruption following total knee arthroplasty (TKA) is an uncommon but serious complication. Surgical management is often complex, particularly in cases of failed reconstruction or persistent instability, and may ultimately necessitate amputation.

We report a 79-year-old female with a history of TKA and prior patellar tendon repair, who developed a fixed flexion deformity and periprosthetic knee dislocation. Given the failure of conventional interventions and compromised soft tissues, she underwent a through-knee amputation. The femoral component of the prosthesis was deliberately retained, a strategy that, to our knowledge, has not previously been described in the literature. Postoperatively, the patient experienced significant pain relief, and the residual limb was suitable for prosthetic fitting, although she elected for wheelchair-based mobility.

Retention of the femoral component during through-knee amputation presents unique surgical challenges but may offer functional and biomechanical advantages, including a stable, end-bearing residual limb and preservation of limb length. This case highlights the feasibility, rationale, and potential benefits of femoral component retention in the context of complex post-TKA limb salvage.

Through-knee amputation with retention of the femoral component represents a novel salvage approach in selected patients with failed TKA reconstruction, providing both anatomical and functional advantages while broadening the management strategies for complex knee arthroplasty complications.