title: Evaluation of quality of life and walking ability among amputated patients and those who refused to undergo amputation following infection of total knee arthroplasty: Small case series.
abstract: BACKGROUND
  Patients who undergo transfemoral amputation after infection of a total knee arthroplasty do not have good functional outcomes and have major difficulty walking.
  
  
  OBJECTIVE
  To evaluate the quality of life and walking ability among patients who underwent amputation and among those who refused to undergo amputation following infection of a total knee arthroplasty.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  Patients who received an indication for amputation following an infection of a total knee arthroplasty were evaluated retrospectively. The patients were divided between those who accepted the amputation procedure and those who refused amputation (four amputee vs four non-amputees). Walking ability and quality of life were evaluated using the Short Form-36 questionnaire.
  
  
  RESULTS
  The average physical health was 27.4 for the amputees and 31.3 for the non-amputees. The average mental health was 49.9 for the amputees and 47.1 for the non-amputees. In relation to walking ability, only one (25%) of the amputees was able to walk, as opposed to 100% in the non-amputee groups.
  
  
  CONCLUSIONS
  Twenty-five percent of the amputee patients continued to be able to walk. The functional outcome of non-amputee patients was better, with 100% being able to walk, though with limitations.
  
  
  CONCLUSIONS
  This is the first study evaluating patients who refused the amputation procedure and remained with the spacer. Despite the fact that this option is not recommended by the medical community, we believe that these data are useful when discussing, with a patient, quality of life after amputation.
authors: Institute of Orthopedics and Traumatology, University of São Paulo, São Paulo, Brazil camilo_helito@yahoo.com.br.
authors: Camilo Partezani
authors: CP
authors: Helito
authors: Institute of Orthopedics and Traumatology, University of São Paulo, São Paulo, Brazil.
authors: Andre Thiago Scandiuzzi
authors: AT
authors: de Brito
authors: Institute of Orthopedics and Traumatology, University of São Paulo, São Paulo, Brazil.
authors: Riccardo Gomes
authors: RG
authors: Gobbi
authors: Institute of Orthopedics and Traumatology, University of São Paulo, São Paulo, Brazil.
authors: Marco Kawamura
authors: MK
authors: Demange
authors: Institute of Orthopedics and Traumatology, University of São Paulo, São Paulo, Brazil.
authors: Luis Eduardo P
authors: LE
authors: Tirico
authors: Institute of Orthopedics and Traumatology, University of São Paulo, São Paulo, Brazil.
authors: Jose Ricardo
authors: JR
authors: Pecora
authors: Institute of Orthopedics and Traumatology, University of São Paulo, São Paulo, Brazil.
authors: Gilberto Luis
authors: GL
authors: Camanho
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical / Q000379:methods / Q000534:rehabilitation*; D000674:Amputees / Q000523:psychology; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000379:methods; D001186:Artificial Limbs; D001938:Brazil; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017755:Prosthesis Fitting / Q000379:methods; D016459:Prosthesis-Related Infections / Q000175:diagnosis* / Q000601:surgery*; D011788:Quality of Life; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D012494:Sampling Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D016312:Treatment Refusal; D016138:Walking / Q000502:physiology*
keywords: Amputee; arthroplasty; knee infection; walking aid