| Age at AKA | Gender | BMI (kg/m2) | Smoker | Alcohol abuse | ASA | Relevant comorbidities, patient particularities | Type of infection | Initial strategy | Anemia | Hb (g/dl) | Microrga-nism(s) | Surgeries (total) | Indication for AKA |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1 | 86 | f | 44.4 | no | no | 3 | DM, AH, morbid obesity, severe malnutrition, inguinal mykosis, CRI, ncnc anemia, UTI | chronic/ delayed | AKA | yes | 109 | CNS | 3 | Chronic TKA-dislocation and PJI. Ongoing deterioration in spite of TKA explantation and antibiotic treatment. Low functional demand. |
2 | 77 | f | 51.9 | no | no | 3 | AH, AF, morbid obesity, severe malnutrition, COPD, s/p ARI, inguinal mycosis, ncnc anemia, thyroid dysfunction, recurrent UTI, s/p sepsis (Enterobacter) faecium) | acute/ early | DAIR | yes | 79 | polymicrobial | 4 | Infection control impossible in spite of repeated radical surgical interventions and antibiotic/antimycotic treatment. |
3 | 84 | m | 26.8 | no | no | 3 | Myelodysplastic syndrome with anemia; immunosuppressive therapy with Azacitin and steroids; unclear lung disease (Asbestosis?) | acute/ early | staged revision arthroplasty | yes | 88 | strept. sp. | 2 | Infection control impossible in spite of TKA-explantation and antibiotic treatment. Sepsis. Involvement of lower leg with non-vital musculature. |
4 | 54 | m | 25.8 | yes | yes | 2 | indication for TKA: open tibial plateau fracture with neurological compromise (Gustilo 3C), treated with megaprosthesis myocutaneus flap andinterpolated gastroc/soleusflap | acute/ early | AKA | yes | 128 | anaerobic bact. | 3 | Megaprothesis. Arthrodesis with fibula autograft considered but patient prefers AKA in favour of maintaining the integrity of the contralateral limb. |
5 | 74 | f | 43.8 | no | no | 3 | AH, sick-sinus-syndrome, CRI, inguinal mycosis, recurrent PE, COPD, CVI, ncnc anemia | acute/ early | staged revision arthroplasty | yes | 101 | CNS | 8 | Infection control impossible. Long term antibiotic suppression therapy badly tolerateds. Extensor mechanisme insufficient. Low demand patient. |
6 | 88 | f | 18.6 | yes | no | 3 | DM, iron deficiency anemia, carotis bifurcation stenosis, PAOD, CVD, CHF, AF, recurrent UTI | acute/ early | DAIR | yes | 93 | S. aureus | 5 | Infection control impossible in spite of repeated radical surgical interventions and antibiotic/antimycotic treatment. PAOD. |
7 | 49 | m | 22.5 | yes | no | 3 | HIV, Hepatitis A/B/C, polytoxicomania, tricuspid insufficiency, COPD, beta thalassemia, bilateral pneumonia | acute/ early | AKA | yes | 89 | C. albicans | 8 | Failed arthrodesis. Continued infection. |
8 | 72 | f | 23.3 | no | no | 3 | RA treated with Methotrexate and Humira; anticoagulation for recurrent PE; bilateral AKA for PJI | acute/ early | DAIR | yes | 98 | polymicrobial | 21 | Infection control impossible in spite of repeated radical surgical interventions and antibiotic treatment. Pain. |
9 | 49 | m | 22.8 | yes | yes | 3 | epilepsy, gastric ulcer, s/p postoperative MOF | acute/ early | DAIR | yes | 98 | polymicrobial | 17 | Infection control impossible in spite of repeated radical surgical interventions and antibiotic treatment. Persistant intraarticular bleeding due to coagulation disorder. |
10 | 62 | m | 21.1 | yes | no | 3 | DM, AH, s/p middle lobectomy for pulmonary squamous cell carcinoma, CVI, steroids for polyarthralgia, lingual carcinoma, GERD | chronic/ delayed | staged revision arthroplasty | yes | 77 | polymicrobial | 14 | Persistent fistulating osteomylitis in spite of repeated radical surgical interventions and antibiotic treatment. |
11 | 71 | f | 23.3 | no | no | 3 | RA treated with Methotrexate and Humira; anticoagulation for recurrent PE; bilateral AKA for PJI | acute/ early | DAIR | yes | 114 | strept. sp. | 24 | Infection control impossible in spite of repeated radical surgical interventions and antibiotic treatment. Pain. |