Amputation as a Complication after Total Knee Replacement, Is It a Real Concern to be Discussed?: A Systematic Review

Document Type : SYSTEMATIC REVIEW

Authors

1 Orthopedic Research center, Mashhad university of Medical Sciences, Mashhad, Iran

2 Department of Orthopedic Surgery, Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Abstract

Total knee replacement (TKR) is a growing attractive treatment for a degenerative knee disease. However, there
remain some certain devastating complications to be discussed with patients preoperatively, including limb
amputation. This systematic review aimed to determine the rate of amputation following TKR. In this study, the
literature was searched up to 2019. The papers were included in which knee amputation was reported following
TKR. The primary search concluded the articles from EMBASE, SCOPUS, PubMed, Web of Science, MEDLINE,
OvidSP, CINAHL, EBSCO, Web of Science™, and CENTRAL. After screening and excluding case reports, 40
papers were included in the present study. The present review showed that amputation is a real end result of
knee replacements either in primary or revision knee arthroplasties, which needs to be discussed with patients
for their decision-making. Prevalence of amputation in terms of failure or complications after TKR procedures was
estimated between 0.1-10% in different studies , with 5.1% amputation rate in infected TKR and 0.025% amputation
rate in primary TKR as a result of infection in our review. Deep infection was the main cause of amputation.
Vascular complications and fractures associated with bone loss and compartment syndrome were other reasons
for amputation.
Level of evidence: III

Keywords


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