Document Detail


Functional ability after above-the-knee amputation for infected total knee arthroplasty.
MedLine Citation:
PMID:  20886323     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Prosthetic joint infection is an uncommon but serious complication of total knee arthroplasty (TKA). Control of infection after TKA is not always possible, and the resolution of infection may require an above-knee amputation (AKA).
QUESTIONS/PURPOSES: The purpose of this study was to determine the etiology of AKA and the functional outcomes of AKA after infected TKA.
METHODS: We retrospectively reviewed 35 patients who underwent AKA after an infected TKA. The amputations were performed an average of 6 years (range, 21 days to 24 years) after primary TKA. There were 19 females and 16 males with a mean age of 62 years (range, 26-88 years). Patient demographic information, comorbidities, surgical treatments, cultures, and culture sensitivities were recorded. Complications and functional status, including SF-12 and activities of daily living questionnaires, after AKA were also studied. The minimum followup was 7 months (mean, 39 months; range, 7-96 months).
RESULTS: Two patients died secondary to cardiac arrest and 13 more died during the followup period of unrelated causes. Nine patients required irrigation and débridement for nonhealing wounds after AKA and two patients had repeat AKA for bony overgrowth. Of the 14 patients fitted for prostheses, eight were functionally independent outside of the home. Patients fitted with a prosthesis had higher mean activities of daily living scores (58 versus 38) and also tended to be younger with fewer comorbidities than those who were not fitted with a prosthesis.
CONCLUSIONS: We found low functional status in living patients with an AKA after infection with only half of the patients walking after AKA.
LEVEL OF EVIDENCE: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
Authors:
Catherine J Fedorka; Antonia F Chen; William M McGarry; Javad Parvizi; Brian A Klatt
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Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  469     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-03-04     Completed Date:  2011-05-12     Revised Date:  2013-07-03    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1024-32     Citation Subset:  AIM; IM    
Affiliation:
Jefferson Medical College, Philadelphia, PA, USA.
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MeSH Terms
Descriptor/Qualifier:
Activities of Daily Living
Adult
Aged
Aged, 80 and over
Amputation*
Arthroplasty, Replacement, Knee / adverse effects*,  instrumentation
Debridement
Disability Evaluation
Female
Humans
Infection Control / methods*
Knee Joint / microbiology,  physiopathology,  surgery*
Knee Prosthesis / adverse effects*
Male
Middle Aged
Pennsylvania
Prosthesis-Related Infections / diagnosis,  microbiology,  surgery*
Questionnaires
Recovery of Function
Reoperation
Retrospective Studies
Therapeutic Irrigation
Time Factors
Treatment Outcome
Walking
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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