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. 2013 Oct 9;48(5):406-411.
doi: 10.1016/j.rboe.2012.07.011. eCollection 2013 Sep-Oct.

Amputation after failure or complication of total knee arthroplasty: prevalence, etiology and functional outcomes

Alan de Paula Mozella  1 , Idemar Monteiro da Palma  1 , Alberto Ferreira de Souza  2 , Guilherme Ornellas Gouget  2 , Hugo Alexandre de Araújo Barros Cobra  3
Affiliations

Amputation after failure or complication of total knee arthroplasty: prevalence, etiology and functional outcomes

Alan de Paula Mozella et al. Rev Bras Ortop. .

Abstract
in English, Portuguese

Objective: Identify the etiology and incidence, as well to assess functional outcomes of patients, undergoing lower limb amputation after failure or complication of total knee arthroplasty. These patients were treated at the Center for Knee Surgery at the National Institute of Traumatology and Orthopedics (INTO), during the period of January 2001 to December 2010.

Methods: The patients were interviewed and their charts were retrospectively analyzed to evaluate their functional outcome.

Results: The incidence of amputation due to failure or complication of total knee arthroplasty was 0.41% in 2409 cases. Recurrent deep infection was the cause of amputation in 81% of cases, being Staphylococcus aureus and Pseudomonas aeruginosa the most frequent germs. Vascular complications and periprosthetic fracture associated to metaphyseal bone loss were also causes of amputation. In our study, 44% of amputees patients were using orthesis and 62.5% have had the ability to walk.

Conclusion: Incidence of 0.41%, being the main cause recurrent infection. The functional outcome is limited, and the fitting achieved in 44% of patients and only 62.5% are ambulatory.

Objetivo: Identificar a etiologia e a incidência da amputação do membro inferior após falha ou complicação da artroplastia total de joelho e avaliar os resultados funcionais dos pacientes tratados pelo Centro de Cirurgia de Joelho do Instituto Nacional de Traumatologia e Ortopedia (Into) entre janeiro de 2001 e dezembro de 2010.

Métodos: Os prontuários foram retrospectivamente analisados para coleta dos dados e entrevista para avaliação do resultado funcional.

Resultados: A incidência de amputação em decorrência de falha ou complicação após 2.409 artroplastias totais de joelho foi de 0.41%. Infecção profunda recorrente foi causa de amputação em 81% dos casos. Os germes mais frequentes foram Staphylococcus aureus e Pseudomonas aeruginosa. Complicações vasculares e fratura periprotética associada a perda óssea metafisária representaram indicação em menor número de casos. Em nosso estudo, 44% dos pacientes amputados apresentam–se protetizados e 62.5% apresentavam capacidade de deambulação.

Conclusões: Incidência de 0.41% e principal causa infecção recorrente. O resultado funcional é limitado, a protetização foi alcançada em 44% dos pacientes e somente 62.5% são deambuladores.

Keywords: Amputation; Arthroplasty knee replacement; Postoperative complications.

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Figures

Fig. 1
Fig. 1
Patient amputated due to infection after TKA.
See this image and copyright information in PMC

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