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Patients with chronically infected TKA satisfied with above-knee amputations
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Patients with chronically infected total knee arthroplasties were satisfied with outcomes after an above-knee amputation despite poor function, according to study results.
Through a retrospective chart review, researchers identified seven patients who received above-knee amputations (AKAs) for the treatment of an infected total knee arthroplasty (TKA). In an in-depth interview, one patient provided perspective on important issues to consider when deciding to receive an AKA. Based on these responses and questions from other published questionnaires, the researchers created a post-AKA questionnaire. In addition, patients were asked to answer the SF-12 questionnaire evaluated mental and physical scores. The researchers also analyzed patients’ overall medical condition with the American Society of Anesthesia score. Average follow-up was 15.3 months.
Six of seven patients were fitted with a prosthetic limb post-amputation. Due to morbid obesity of the leg, one patient was not able to be fitted for a prosthesis and was wheel chair bound, according to the researchers.
Out of the five patients fitted with prostheses, four reported being able to wear the prosthetic limb for longer than 1 hour a day, whereas two patients reported wearing it for less than 1 hour per day.
Results indicated in three patients, complications with the amputations had developed. One patient felt phantom limb pains and two needed stump revision in order to achieve wound closure. All wounds had healed at the latest follow-up, according to the researchers.
No correlation was observed between number of procedures before AKA and patient satisfaction or SF-12 scores.
Although statistical significance was not achieved, greater average SF-12 scores were observed in patients who had flaps followed by AKA, suggesting that for patients with more complex problems — those who have infections with concomitant severe soft tissue — loss may benefit from earlier AKA, according to the researchers. ‒ by Monica Jaramillo
Disclosures: Khanna reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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