Through-knee amputation: mediolateral fasciocutaneous flaps with the addition of a protective gastrocnemius layer

Eid-Arimoku, L; Brooks, Michael K.

doi:10.1308/rcsann.2019.0127

Cited by 2 publications

(6 citation statements)

References 2 publications

(5 reference statements)

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“…13 The patella is retained, and the patellar tendon is attached to the cruciate ligaments; however some authors do not detail if or where the patella tendon is re-attached. 16 Flaps can be sagittal, lying posteriorly, vertically between the condyles 12,13,[19][20][21] or transverse, with the scar horizontally at the distal end of the residual limb, below, anteriorly or posteriorly. [14][15][16][17][18] A preferred technique regarding flaps has not emerged.…”

Section: Techniquesmentioning

confidence: 99%

“…4,[9][10][11][12][13]17,19 Survival rates between techniques are inconsistent, ranging from 84% to 100% for all techniques. 12,16,19,23,24,29 For the classical approach, survival rates of 56% after one year 18 and 72% after an undefined period 21 are reported. For the Mazet technique, 60% at three years and 44% at five years are reported.…”

Section: Outcomes Reportedmentioning

confidence: 99%

“…Classical approach. In the classical approach [Figure 1(a)], the femur is left intact, 4,[11][12][13][14][15][16][17][18][19][20] except for the technical modification described by Vaucher and Blanc 21 where the femoral condylar cartilage and corners are excised to reduce the size of the condyles. The menisci are removed, except by Baumgartner (1979) who reported that the menisci could 'add cover' to the weight bearing femoral condyles in non-vascular patients.…”

Section: Techniquesmentioning

confidence: 99%

“…5,34 Of the 26 articles presenting TKA surgical techniques, 8 present both operative and functional outcomes, 20,22,[24][25][26][29][30][31] eight present only operative outcomes, 14,16,18,21,27,28,32,33 two present only functional outcomes 15,23 and eight present no outcomes (Table 2). 4,[9][10][11][12][13]17,19 Survival rates between techniques are inconsistent, ranging from 84% to 100% for all techniques. 12,16,19,23,24,29 For the classical approach, survival rates of 56% after one year 18 and 72% after an undefined period 21 are reported.…”

Section: Outcomes Reportedmentioning

confidence: 99%

“…All techniques had similar revision rates from TKA to AKA under 20%. 9,12,30,17,19,21,[23][24][25][26][27] A subset of articles report maintenance of gait measures. Albino et al (2014) noted that trauma patients and those under the age of 50 years were more likely to walk following their amputation, highlighting the importance of aetiology and patient factors in influencing the return to walking following amputation.…”

Section: Outcomes Reportedmentioning

confidence: 99%

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A review of through-knee amputation

et al. 2021

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Objectives Through-knee amputation is an umbrella term for several different surgical techniques, which may affect clinical and functional outcomes. This makes it hard to evaluate the benefits and need for a through-knee amputation approach. This article seeks to (1) determine the number of through-knee amputation performed compared with other major lower limb amputations in England over the past decade; (2) identify the theoretical concepts behind through-knee amputation surgical approaches and their potential effect on functional and clinical outcomes and (3) provide a platform for discussion and research on through-knee amputation and surgical outcomes. Methods National Health Service Hospital Episodes Statistics were used to obtain recent numbers of major lower limb amputations in England. EMBASE and MEDLINE were searched using a systematic approach with predefined criteria for relevant literature on through-knee amputation surgery. Results In the past decade, 4.6% of major lower limb amputations in England were through-knee amputations. Twenty-six articles presenting through-knee amputation surgical techniques met our criteria. These articles detailed three through-knee amputation surgical techniques: the classical approach, which keeps the femur intact and retains the patella; the Mazet technique, which shaves the femoral condyles into a box shape and the Gritti-Stokes technique, which divides the femur proximal to the level of the condyles and attaches the patella at the distal cut femur. Conclusions Through-knee amputation has persisted as a surgical approach over the past decade, with three core approaches identified. Studies reporting clinical, functional and biomechanical outcomes of through-knee amputation frequently fail to distinguish between the three distinct and differing approaches, making direct comparisons difficult. Future studies that compare through-knee amputation approaches to one another and to other amputation levels are needed.

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