Quality of Life and Outcomes After Treatment Failure for Recurrent PJI of TKA
Multicenter retrospective study comparing outcomes of above-knee amputation (AKA), permanent spacers, and knee arthrodesis in patients with recurrent periprosthetic joint infection (PJI) of the knee after failed revisions.
A total of 86 patients (35 AKA, 43 spacer, 8 arthrodesis) were evaluated for quality of life (SF-36), pain (VAS, DN4), complications, and functional outcomes.
🧠 Key Points
AKA patients had better quality of life scores (higher SF-36 general health and role-physical scores) compared to spacers.
Pain relief was superior in AKA (lower VAS and DN4) than both spacer and arthrodesis.
Complication and reoperation rates were highest with spacers (53% and 42%) vs. lowest with AKA (14% each).
Functional mobility: AKA patients more often walked >1 mile (26% vs. 5% with spacer) and were more frequently able to drive (42% vs. 23%).
Mortality and reinfection rates were similar across groups at 2 years.
Conclusion: AKA should not only be a last resort—it offers better pain control, fewer complications, and improved QoL in selected patients.
The Journal of Arthroplasty (2025)
doi.org/10.1016/j.arth.2025.08.017