Amputation as a devastating complication of total knee arthroplasty: systematic review

Backhrounds Total knee replacement is a growing attractive alternative for any noninfected end stage knee disease. Yet there are some certain devastating complicationsto be discussed with patient preoperatively. Limb amputation is one of these potentialend stage results. Our objective was to find all reported amputation cases related tototal knee replacement.Methods We made a through literature review between 2017-2005 aimed to find anypaper which reported knee amputation in their short or long term follow ups. 9398article were extracted from EBASE, SCOPUS, PubMed, Web of Science, MEDLINE, OvidSP, CINAHL (EBSCO), Web of Science™, and Cochrane. Included studies were level 3 or4 on evidences including registries, follow up studies , case series and case reports. Keywords were all relevant expressions of (total knee replacement) and (complication oramputation or results or outcome). With title screening 536 articles were screened.99 item were duplicated. Two researchers reviewed 437 full texts. 60 papers had beenreported our intended outcome (Amputation). 15 were excluded because they werecase reports.Results 70621 cases resulting from 45 studies were reported total of 41 amputationsas end result (%0.05). Infection, fracture and bone losses, vascular complication andcompartment syndrome consisted all reported causes of amputation with infection as%96 of all cases. Amputation was as %3.9 in infected total knee arthroplasties.Conclusions amputation is a real end result for knee replacements either in primaryor revision knee arthroplasties which needs to be discussed with patients for theirdecision making.