Please login to view this media
- Talk
- 15/06/2021
- Canada
Contemporary Outcomes of Transfemoral Amputations After Total Knee Arthroplasty: A Comparison of Indications
Description
This presentation by Dr. Matthew Shirley addresses the outcomes of transfemoral amputation following total knee arthroplasty (TKA), primarily focusing on the reasons for amputation, patient survival, prosthetic fitting, mobility, and overall satisfaction.
Dr. Shirley commences by discussing the context in which transfemoral amputation is considered, stating that it is often seen as a salvage option when TKA is unsuccessful, particularly due to complications such as infections. He indicates a gap in existing research concerning how different indications for amputation affect patient outcomes, highlighting the need for a clearer comparison of subgroups.
The study involved a retrospective analysis of 127 patients who underwent transfemoral amputation after TKA, divided into two distinct groups based on the indication for amputation: Group one included patients whose amputations were related to knee arthroplasty (mainly due to infection), while Group two encompassed those with non-arthroplasty-related reasons (predominantly peripheral vascular disease).
Noteworthy findings include approximately 50% survival at four years post-amputation for all patients, with no significant differences in outcome based on the amputation's indication. However, it was revealed that patients in Group one had a higher instance of perioperative death in the first three months after surgery. Furthermore, patients receiving amputations after 2000 had a significantly increased likelihood of being fitted with a prosthetic limb, correlating with advancements in prosthetic technology.
In terms of patient self-reported outcomes, those from the Group one exhibited lower quality of life ratings and less satisfaction compared to their peers in Group two, despite being more likely to be fitted with prosthetics. Despite the overall poor survival rates, advancements in technology leading to improved prosthetic fitting post-amputation underscore the importance of transfemoral amputation as a salvage solution in severe cases of TKA failure. The presenter concludes with a caution for both patients and healthcare providers about the realities of survival and satisfaction outcomes accompanying such surgeries.