Evidence map›Paper›PMID 39327266›Full record

SynthesisArchives of orthopaedic and trauma surgery2024

High mortality rate and restricted mobility in above knee amputation following periprosthetic joint infection after total knee arthroplasty: A systematic review.

Ashraf T Hantouly, Jad Lawand, Osama Alzobi, Amir Human Hoveidaei, Loay A Salman, Shamsi Hameed, Ghalib Ahmed, Mustafa Citak

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Archives of orthopaedic and trauma surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Ashraf T HantoulyDepartment of Orthopaedic Surgery, Surgical Specialty Center, Hamad Medical Corporation, Doha, Qatar.
Jad LawandUniversity of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555-0569, USA.
Osama AlzobiDepartment of Orthopaedic Surgery, Surgical Specialty Center, Hamad Medical Corporation, Doha, Qatar.
Amir Human HoveidaeiInternational Center for Limb Lengthening, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, MD, USA.
Loay A SalmanDepartment of Orthopaedic Surgery, Surgical Specialty Center, Hamad Medical Corporation, Doha, Qatar.
Shamsi HameedDepartment of Orthopaedic Surgery, Surgical Specialty Center, Hamad Medical Corporation, Doha, Qatar.
Ghalib AhmedDepartment of Orthopaedic Surgery, Surgical Specialty Center, Hamad Medical Corporation, Doha, Qatar.
Mustafa CitakDepartment of Orthopaedic Surgery, HELIOS ENDO-Clinic Hamburg, 222767, Holstenstraße, Hamburg, Germany. mcitak@gmx.de.ORCID http://orcid.org/0000-0003-3207-7101

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo systematically review the literature on the outcomes of above knee amputation as a salvage procedure after periprosthetic joint infection in total knee arthroplasty.

methodsThis systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Medline, Scopus, Web of Science, and Embase electronic databases were utilized to identify all studies evaluating clinical outcomes of patients with above knee amputation following PJI from inception to June 24, 2023. Studies were excluded for failure to report functional outcomes specifically related to AKA in PJI following TKA, utilizing surgical interventions other than amputation, AKA indicated for other reasons than PJI, technical studies, conference abstracts, case reports and non-English language. The quality of studies was assessed with the Methodological Index for Non-Randomized Studies (MINORS) criteria.

resultsSeven retrospective studies, categorized as Therapeutic Level III evidence, were analyzed, involving a total of 188 patients who underwent AKA following PJI after TKA. The findings consistently indicate that post-AKA, patients experienced a notable decline in their level of independence and reported worsening ambulatory status. Infection and wound complications were common post-AKA, leading to revision surgeries, while the mortality rate ranged from 9 to 50% in the included studies. Polymicrobial organisms were frequently found in pre-AKA PJI, with MRSA being a common causative organism.

conclusionsAKA due to PJI following TKA is associated with restricted mobility and high mortality rate. Polymicrobial infections and MRSA were identified as common infecting organisms, emphasizing the complexities and challenges associated with managing these infections. The reported functional outcomes, ambulatory status, complications, reoperations, and mortality rates highlight the importance of providing comprehensive, individualized care to these patients.

Indexed as

Amputation, SurgicalArthroplasty, Replacement, KneeProsthesis-Related InfectionsHumansKnee ProsthesisMobility LimitationReoperationAmputationArthroplastyKneePeriprosthetic joint infection

Identifiers

PMID39327266

What OpenQuestion holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.