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Transfemoral amputation following total knee arthroplasty: mortality and functional outcomes.

Publication ,  Journal Article
Ryan, SP; DiLallo, M; Klement, MR; Luzzi, AJ; Chen, AF; Seyler, TM
Published in: Bone Joint J
February 2019

AIMS: The aim of this study was to characterize the factors leading to transfemoral amputation after total knee arthroplasty (TKA), as well as the rates of mortality and functional independence after this procedure in these patients. PATIENTS AND METHODS: This was a multicentre retrospective review with a prospective telephone survey for the assessment of function. All patients with a TKA who subsequently required transfemoral amputation between January 2001 and December 2015 were included. Demographic information, medical comorbidities, and postoperative mortality data were collected. A 19-item survey was used for the assessment of function in surviving patients. RESULTS: A total of 111 patients were included. Their mean age was 61.0 years (42.0 to 88.0) at the time of TKA, with a subsequent mean of 3.7 operations (0 to 15) over a mean period of 6.1 years (0.05 to 30.1) before amputation. The indication for amputation was chronic infection in 97 patients (87.4%). The rate of five-year survival was 51.7%, and advanced age (p = 0.001) and renal failure (p = 0.045) were associated with an increased risk of mortality. Of the 62 surviving patients, 34 completed the survey; 32 (94.1%) owned a prosthesis but only 19 (55.9%) used it; 19 (55.9%) primarily used a wheelchair for mobility; 27 (79.5%) had phantom pain; and 16 (47.1%) required chronic pain medication. Only 18 patients (52.9%) were satisfied with the quality of life. CONCLUSION: Patients with complications after TKA, in whom transfemoral amputation is considered, should be made aware of the high rate of mortality and the poor functional outcome in the survivors. Alternative forms of treatment including arthrodesis of the knee should be investigated.

Duke Scholars

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Published In

Bone Joint J

DOI

EISSN

2049-4408

Publication Date

February 2019

Volume

101-B

Issue

2

Start / End Page

221 / 226

Location

England

Related Subject Headings

  • Retrospective Studies
  • Recovery of Function
  • Quality of Life
  • Prosthesis-Related Infections
  • Middle Aged
  • Male
  • Lower Extremity
  • Ischemia
  • Humans
  • Femur
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Ryan, S. P., DiLallo, M., Klement, M. R., Luzzi, A. J., Chen, A. F., & Seyler, T. M. (2019). Transfemoral amputation following total knee arthroplasty: mortality and functional outcomes. Bone Joint J, 101-B(2), 221–226. https://doi.org/10.1302/0301-620X.101B2.BJJ-2018-0784.R1
Ryan, S. P., M. DiLallo, M. R. Klement, A. J. Luzzi, A. F. Chen, and T. M. Seyler. “Transfemoral amputation following total knee arthroplasty: mortality and functional outcomes.Bone Joint J 101-B, no. 2 (February 2019): 221–26. https://doi.org/10.1302/0301-620X.101B2.BJJ-2018-0784.R1.
Ryan SP, DiLallo M, Klement MR, Luzzi AJ, Chen AF, Seyler TM. Transfemoral amputation following total knee arthroplasty: mortality and functional outcomes. Bone Joint J. 2019 Feb;101-B(2):221–6.
Ryan, S. P., et al. “Transfemoral amputation following total knee arthroplasty: mortality and functional outcomes.Bone Joint J, vol. 101-B, no. 2, Feb. 2019, pp. 221–26. Pubmed, doi:10.1302/0301-620X.101B2.BJJ-2018-0784.R1.
Ryan SP, DiLallo M, Klement MR, Luzzi AJ, Chen AF, Seyler TM. Transfemoral amputation following total knee arthroplasty: mortality and functional outcomes. Bone Joint J. 2019 Feb;101-B(2):221–226.

Published In

Bone Joint J

DOI

EISSN

2049-4408

Publication Date

February 2019

Volume

101-B

Issue

2

Start / End Page

221 / 226

Location

England

Related Subject Headings

  • Retrospective Studies
  • Recovery of Function
  • Quality of Life
  • Prosthesis-Related Infections
  • Middle Aged
  • Male
  • Lower Extremity
  • Ischemia
  • Humans
  • Femur