Functional outcomes in quadruple arthroplasty of the hips and knees: A literature review of 306 cases with a minimum follow-up of 2 years

Quadrupled arthroplasties of the lower limb are required mostly in cases with chronic and severe inflammatory arthritis. There may be a requirement of additional surgery for the foot and ankle or joints of an upper limb, especially in inflammatory arthritis, to improve the functional outcomes. The patient's self-motivation and patient selection for four joint arthroplasties are necessary for favorable outcomes. Surgical technique, prosthetic design, and postoperative rehabilitation play a vital role in functional outcomes. More multicenter, large series and registries are required with long-term follow-up in the future to frame the clinical practice guidelines.