Amputation as a Complication after Total Knee Replacement, Is It a Real Concern to be Discussed?: A Systematic Review

Total knee replacement (TKR) is a growing attractive treatment for a degenerative knee disease. However, thereremain some certain devastating complications to be discussed with patients preoperatively, including limbamputation. This systematic review aimed to determine the rate of amputation following TKR. In this study, theliterature was searched up to 2019. The papers were included in which knee amputation was reported followingTKR. 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, 40papers were included in the present study. The present review showed that amputation is a real end result ofknee replacements either in primary or revision knee arthroplasties, which needs to be discussed with patientsfor their decision-making. Prevalence of amputation in terms of failure or complications after TKR procedures wasestimated between 0.1-10% in different studies , with 5.1% amputation rate in infected TKR and 0.025% amputationrate 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 reasonsfor amputation.Level of evidence: III