Above-the-knee amputation after a total knee replacement: prevalence, etiology, and functional outcome

The Journal of Bone and Joint Surgery. American Volume
Rafael J SierraMark W Pagnano

Abstract

Despite modern surgical techniques, salvage of a failed total knee replacement remains a challenge. In certain situations, when other treatment options have been exhausted, patients with a failed total knee replacement may become candidates for above-the-knee amputation. The objective of this study was to assess the prevalence, etiology, and functional outcome of above-the-knee amputation performed proximal to an ipsilateral total knee replacement. From 1970 to 2000, 18,443 primary total knee replacements were performed at our institution; sixty-seven (0.36%) were eventually followed by above-the-knee amputation. Forty-two of the amputations were performed for a cause unrelated to the total knee replacement, most commonly peripheral vascular disease (twenty-four knees). The remaining twenty-five above-the-knee amputations were performed for causes related to the total knee replacement: nineteen were done for uncontrollable infection; two, for periprosthetic fracture; two, for pain; one, for severe bone loss; and one, for a vascular complication. The twenty-five above-the-knee amputations performed for causes related to the total knee replacement were done at an average of 8.6 years (range, eight days to 23.6 years) after the re...Continue Reading

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