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· DOS Abstracts
Amputation after failed knee arthroplasty
Tinne B Gottfriedsen Tinne Brandt Gottfriedsen,
Anders Odgaard, Henrik M Schrøder
Department of Orthopaedics, Copenhagen University Hospital Gentofte
Background:
Existing data on amputation for failed knee arthroplasty is limited.
Data from the Danish Knee Arthroplasty Register (DKR) suggests that only 3
amputations have been performed since 1997.
Purpose / Aim of Study:
To identify the incidence and causes of above knee
amputation after failed knee arthroplasty.
Materials and Methods:
Nationwide data was extracted from the Danish
Hospital Episodes Statistics and DKR. Relevant patient notes were retrospec-
tively reviewed.
Findings / Results:
We identified 89,545 primary knee arthroplasties per-
formed in Denmark from 1997-2013. 250 arthroplasties were followed by
amputation corresponding to an overall crude incidence of 0.28%. Of these,
111 were performed for causes related to the knee arthroplasty corresponding
to an incidence of 0.12% (range among regions, 0.07-0.16%, p=0.42). Survival
data will be presented. Mean age was 69.1 years (66.9-74.5, p=0.80). Mean
time between primary arthroplasty and amputation was 4.1 years (1.8-5.5,
p=0.16). The patients underwent an average of 2.7 knee surgeries prior to
amputation including arthrodesis in 23 cases (1.7-3.8, p=0.06). 54% of cases
were assessed at a highly specialised hospital (18-90%, p=0.001). Indications
for amputation included infection in 91 cases (82%), soft tissue deficiencies in
24 cases (22%), bone loss in 20 cases (18%), extensor mechanism disruption
in 11 cases (10%), pain in 10 cases (9%), periprosthetic fracture in 10 cases
(9%) and vascular complications in 9 cases (8%). In 88 cases (79%) there were
at least two or more indications for amputation.
Conclusions:
We found significantly more amputations than reported to DKR.
56% of these were performed for causes other than failed knee arthroplasty.
The majority of amputations related to failed knee arthroplasty were performed
for several indications, of which infection was present in most cases.
157.
