Efficacy of Physical Therapy following an Above-Knee Amputation after an Infected Right Total Knee Arthroplasty in a 75-Year-Old-Male

Document Type

Poster

Start Date

28-4-2026 12:00 PM

End Date

28-4-2026 2:00 PM

Description

Introduction: Periprosthetic joint infection (PJI) following total knee arthroplasty (TKA) is a rare but devastating complication that may ultimately require above-knee amputation (AKA), with consistently poor functional outcomes reported in the literature.

Purpose: To describe the outpatient rehabilitation management and functional outcomes of a 75-year-old male who underwent right AKA secondary to persistent PJI after TKA.

Methods: The patient participated in outpatient physical therapy three times weekly for 10 weeks, emphasizing progressive hip and core strengthening, task-specific prosthetic gait training, neuromuscular re-education, and endurance conditioning. Outcome measures included the Amputee Mobility Predictor with prosthesis (AMPpro), Lower Extremity Functional Scale (LEFS), and 2-Minute Walk Test (2MWT), administered at baseline and 8-week reassessment.

Results: At baseline, the patient ambulated 5 feet with moderate assisstance in parallel bars and scored 9/47 on the AMPpro (K0 level), 10/80 on the LEFS, and was unable to complete the 2MWT. After 8 weeks he ambulated 140 feet with supervision using a front-wheeled walker, improved to 16/47 on the AMPpro (K1 level) and achieved 17.4 meters on the 2MWT. The 7-point AMPpro improvement exceeded the minimal detectable change, indicating clinically meaningful progress. LEFS improved to 15/80. Transfers progressed from moderate assistance to stand-by assistance and prosthetic wear tolerance increased to 6-8 hours daily.

Discussion: Despite advanced age, comorbidities, and prolonged pre-amputation immobility, the patient achieved meaningful gains in mobility. This case highlights the potential for functional recovery in complex post-arthroplasty amputees and supports the integration of progressive strengthening and standardized outcome measures.

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Apr 28th, 12:00 PM Apr 28th, 2:00 PM

Efficacy of Physical Therapy following an Above-Knee Amputation after an Infected Right Total Knee Arthroplasty in a 75-Year-Old-Male

Introduction: Periprosthetic joint infection (PJI) following total knee arthroplasty (TKA) is a rare but devastating complication that may ultimately require above-knee amputation (AKA), with consistently poor functional outcomes reported in the literature.

Purpose: To describe the outpatient rehabilitation management and functional outcomes of a 75-year-old male who underwent right AKA secondary to persistent PJI after TKA.

Methods: The patient participated in outpatient physical therapy three times weekly for 10 weeks, emphasizing progressive hip and core strengthening, task-specific prosthetic gait training, neuromuscular re-education, and endurance conditioning. Outcome measures included the Amputee Mobility Predictor with prosthesis (AMPpro), Lower Extremity Functional Scale (LEFS), and 2-Minute Walk Test (2MWT), administered at baseline and 8-week reassessment.

Results: At baseline, the patient ambulated 5 feet with moderate assisstance in parallel bars and scored 9/47 on the AMPpro (K0 level), 10/80 on the LEFS, and was unable to complete the 2MWT. After 8 weeks he ambulated 140 feet with supervision using a front-wheeled walker, improved to 16/47 on the AMPpro (K1 level) and achieved 17.4 meters on the 2MWT. The 7-point AMPpro improvement exceeded the minimal detectable change, indicating clinically meaningful progress. LEFS improved to 15/80. Transfers progressed from moderate assistance to stand-by assistance and prosthetic wear tolerance increased to 6-8 hours daily.

Discussion: Despite advanced age, comorbidities, and prolonged pre-amputation immobility, the patient achieved meaningful gains in mobility. This case highlights the potential for functional recovery in complex post-arthroplasty amputees and supports the integration of progressive strengthening and standardized outcome measures.