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ObjectiveThe purpose of this study was to evaluate the functional outcomes and satisfaction in periprosthetic knee infection patients after above-the-knee amputation （AKA）. MethodsA review was performed in 13 patients who underwent AKA due to periprosthetic knee infection from October 2010 to August 2022， there were 7 females and 6 males with the median age of 69 （45~ 73） years. The mean number of surgical procedures between primary total knee arthroplasty and AKA was 2.9 times （range： 1 ~ 6）. Patients were segregated into non-elderly group （including patients <65 years old） and elderly group （involving patients ≥65 years old）. Functional outcomes were evaluated by SF-12 and Barthel activities daily living index （Barthel ADL index）. Patient satisfaction was accomplished through a questionnaire. ResultsFour patients died within 6 months after the amputation. Three patients received surgical procedures for recurrent infections after AKA. In the remaining 9 patients，the median time from AKA to the final follow-up was 4.2 （1.9~8.2） years， three patients received surgical procedures for recurrent infections after AKA. Patients in non-elderly group showed better functional outcomes than elderly patients after AKA （both P<0.05）. All patients in non-elderly group were fitted with a prosthesis. Whereas， elderly patients reported a better satisfaction after AKA than young patients. ConclusionYoung PJI patients seemed to have better function and ambulatory ability with high expectation and demand， which made them feel less satisfied about AKA. Meanwhile，despite poor function outcomes due to the less healthy physical condition， the alleviation of financial and psychological burdens resulting from reinfections and multiple surgeries and the less demand in function and daily activities made elderly patients have a good satisfaction after AKA.
RESUMO
BACKGROUND:There are a lot of reports about the association between estrogen receptor α polymorphism and osteoarthritis susceptibility, but the results are stil some controversial. OBJECTIVE:To investigate the relationship between the estrogen receptor α gene PvuII, XbaI site polymorphisms and genetic susceptibility of osteoarthritis. METHODS: A computer-based search of PubMed, web of science, Wanfang, CNKI, Weipu and China Biology Medicine Disc was performed for the published case-control studies addressing the association between estrogen receptor α gene PvuII, XbaI site polymorphism and osteoarthritis susceptibility. Odds radio (OR) and 95% confidence interval were used to analyze the correlation between estrogen receptor α gene PvuII, XbaI site polymorphism and osteoarthritis. Fixed or random effect models were selected for pooledOR calculation. Publication bias was assessed. Al statistical analysis was constructed with Revman5.1 software. RESULTS AND CONCLUSION:Nine case-control studies including 3 228 cases of osteoarthritis and 6 327 healthy controls were included. Overal, the pooledOR values of PvuII loci aleles and genotypes (Cvs. T; CTvs. TT; CCvs. TT; CT+CCvs. TT; CCvs. CT+TT) were less than 1; the pooled OR values of Asian which grouped by region were greater than 1 (except CTvs. TT); the pooledOR values of Europe and the Americas were less than 1. The pooledOR values of XbaI loci aleles and genotypes (Gvs.A; GAvs. AA; GGvs. AA; GA+GGvs. AA; GGvs. GA+AA) were less than 1; the pooledOR values of Asian which grouped by region were less than 1; the pooledOR value of Europe and the Americas were less than 1 (except GGvs.GA+AA). Estrogen receptor α gene PvuII, XbaI site polymorphism is not associated with osteoarthritis susceptibility. However, the susceptibility of PvuII loci in the Asian is a little higher compared with that of the Europeans and American population. On the contrary, the susceptibility of XbaI loci in the recessive genetic model of Europeans and American population is a little higher compared with that of the Asian, suggesting a possible role of ethnic differences in genetic backgrounds.