Mousavian Alireza, Sabzevari Soheil, Ghiasi Shirin, Shahpari Omid, Razi Amin, Ebrahimpour Adel, Ebrahimzadeh Mohammad H
Orthopedic Research center, Mashhad university of Medical Sciences, Mashhad, Iran.
Department of Orthopedic Surgery, Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Arch Bone Jt Surg. 2021 Jan;9(1):9-21. doi: 10.22038/abjs.2020.53892.2692.
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.
全膝关节置换术（TKR）对于退行性膝关节疾病而言，正成为一种越来越有吸引力的治疗方法。然而，术前仍有一些严重的并发症需要与患者讨论，包括肢体截肢。本系统评价旨在确定全膝关节置换术后的截肢率。在本研究中，检索了截至2019年的文献。纳入报道了全膝关节置换术后膝关节截肢情况的论文。初步检索从EMBASE、SCOPUS、PubMed、科学网、MEDLINE、OvidSP、护理学与健康领域数据库、EBSCO、科学网™和考克兰系统评价数据库中获取文章。经过筛选和排除病例报告后，本研究纳入了40篇论文。本评价表明，截肢是初次或翻修膝关节置换术的实际最终结果，需要与患者讨论以供其决策。在不同研究中，全膝关节置换术后因失败或并发症导致的截肢发生率估计在0.1%至10%之间，在我们的综述中，感染性全膝关节置换术的截肢率为5.1%，初次全膝关节置换术因感染导致的截肢率为0.025%。深部感染是截肢的主要原因。血管并发症以及与骨质流失和骨筋膜室综合征相关的骨折是截肢的其他原因。
