Skip to main content

Table 5 Overview 11 patients with AKA for PJI

From: Risk factor analysis for above-knee amputation in patients with periprosthetic joint infection of the knee: a case-control study

 

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.