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Amputation after failed total knee arthroplasty

Z U Isiklar1, G C Landon, H S Tullos

  • 1Joseph Barnhart Department of Orthopedic Surgery, Baylor College of Medicine, Houston, Texas 77030.

Clinical Orthopaedics and Related Research
|February 1, 1994
PubMed
Summary
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Complications from total knee arthroplasty, including chronic infection and bone loss, led to above-knee amputations in eight patients. Earlier consideration of knee fusion (arthrodesis) may prevent these severe outcomes.

Area of Science:

  • Orthopedic Surgery
  • Arthroplasty Complications
  • Limb Amputation

Background:

  • Total knee arthroplasty (TKA) is a common procedure for knee osteoarthritis.
  • Complications following TKA can necessitate further surgical interventions.
  • Revision arthroplasty aims to address issues like infection, loosening, or pain, but may not always be successful.

Purpose of the Study:

  • To analyze the factors leading to above-knee amputation after TKA.
  • To evaluate the outcomes of patients undergoing amputation following TKA complications.
  • To identify potential strategies for improving patient outcomes in complex TKA cases.

Main Methods:

  • Retrospective review of eight patients who underwent nine above-knee amputations between 1983 and 1992.

Related Experiment Videos

  • Analysis of patient demographics, preceding TKA history, reasons for amputation, and time from initial TKA to amputation.
  • Identification of common contributing factors to amputation.

    • Main Results:

    • Nine above-knee amputations were performed in eight patients over a 10-year period.
    • The average time from initial TKA to amputation was 9.7 years.
    • Common indications included chronic infection (8 cases) and intractable pain after aseptic loosening (1 case), often following multiple revision attempts.

    Conclusions:

    • Multiple revision arthroplasties, particularly in the context of chronic infection and significant bone loss, are associated with a high risk of subsequent amputation.
    • Intractable pain is another significant factor contributing to amputation after failed revision surgeries.
    • Earlier consideration of knee arthrodesis (fusion) instead of repeated revision TKA may be a more favorable option to prevent amputation in select challenging cases.