Through-knee versus above-knee amputation for vascular and non-vascular major lower limb amputations

Crane, Hayley; Boam, Gemma; Carradice, Daniel; Vanicek, Natalie; Twiddy, Maureen; Smith, George E.

doi:10.1002/14651858.cd013839.pub2

Cited by 11 publications

(5 citation statements)

References 67 publications

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“…The number of amputations for vascular insufficiency, both with and without diabetes mellitus, at proximal levels above the knee and in the trauma group was much lower. There was no discernible shift in the amputation of tumors [5]. The distribution of the etiological components level showed a distinctive pattern for each cause and for each amputation level [6].…”

Section: Introductionmentioning

confidence: 84%

Physiotherapy Rehabilitation for Above-Knee Amputation Secondary to Infected External Fixation: A Case Report

Biyani,

Arya,

Deshpande

et al. 2024

Cureus

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This case study examines the total physiotherapy care of a 50-year-old male patient, who had a right-sided displaced distal tibia and fibula fracture, a talus fracture due to a road traffic accident, and an above-knee amputation due to a serious infection. Enhancing muscle strength, reducing pain from phantom limbs, avoiding problems, maintaining range of motion, increasing endurance, and promoting functional independence in the postoperative period were the main goals of the patient's rehabilitation. The recovery plan included an intensive four-week program of physiotherapy care. The regimen included a variety of interventions, such as pain management, edema control, wound healing techniques, range of motion (ROM) exercises, muscle strengthening activities, mobility and transfer exercises, cardiovascular endurance training, psychosocial support, education on prosthetic use, and independence in daily living activities. ROM measures, manual muscle testing, and functional independence measure scores were used to evaluate the patient's improvement. The patient's physical health and level of functional independence both exhibited significant improvements, according to the statistics. Following treatment, the patient's ROM, muscle strength, and overall functional independence all improved. The study highlights the positive impacts of physical therapy interventions on the patient's quality of life, mobility, and self-sufficiency following the amputation and subsequent recovery. These findings support the patient's transition to a more self-sufficient and active lifestyle by providing valuable insights into the efficient use of physiotherapy and the comprehensive post-amputation treatment plan.

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Section: Introductionmentioning

confidence: 84%

Physiotherapy Rehabilitation for Above-Knee Amputation Secondary to Infected External Fixation: A Case Report

Biyani,

Arya,

Deshpande

et al. 2024

Cureus

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“…The patient’s knee was preserved, making BKA the most appropriate definitive treatment in comparison to through-knee or above-knee amputation. Maximum functional recovery is achieved in BKA at higher rates than in through-knee or above-knee amputations [ 9 ]. Knee arthrodesis is another alternative definitive treatment to be considered but has been shown to result in significant changes in normal gait kinematics with no increase in knee flexion [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Case Report: Total Knee Arthroplasty in Ipsilateral Below-Knee Amputee

Marrero,

Willard

2024

jocr

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Introduction: Total knee arthroplasty (TKA) has the highest annual incidence among all joint replacement surgeries. Below-knee amputation (BKA) is another common procedure to treat lower-limb-threatening pathologies. These two procedures are commonly performed individually, but an ipsilateral TKA performed on a BKA patient is rare. While ipsilateral amputation is not a contraindication for TKA, it presents orthopaedic surgeons with a unique case and necessitates thoughtful pre-operative planning regarding proper positioning, alignment determination, surgical technique, and rehabilitation for the best outcome. Objectives: We present a case of a patient with a BKA who underwent ipsilateral TKA. Case Report: This patient has a history of osteoarthritis (OA) of the right knee and diabetic neuropathy and underwent a right BKA after sustaining second-degree thermal burns to the bilateral forefeet. The patient was scheduled to undergo elective TKA prior to these injuries but was forced to postpone due to their severity. Following the BKA, the patient regained his ability to ambulate independently with prosthesis but continued to suffer from OA symptoms. The patient was then scheduled for surgery, and a TKA was performed. Results: The patient underwent a TKA and tolerated the surgery well without complications. Appropriate positioning was achieved using a popliteal post. Alignment and tibial cut were checked using fluoroscopy. All components were cemented into position, and the patella was resurfaced. The patient did well postoperatively and was using his prosthesis and ambulating independently at the final follow-up. Keywords: Below-knee amputation, total knee arthroplasty, osteoarthritis.

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“…LLAs are associated with physical impairment that has major mobility and psychological implications on an individual (Roșca et al 2021 ). More specifically, above-knee amputations are associated with higher morbidity (Myers & Chauvin 2023 ), poor rehabilitation outcomes (Crane et al 2021 ), and higher mortality (Hançerli & Doğan 2023 ) when compared with below-knee amputations. Given that over 50% of the participants in this study had above-knee amputations, it is plausible to infer that some may have challenges with returning to their highest level of function.…”

Section: Discussionmentioning

confidence: 99%

The profile of people undergoing lower limb amputations at Groote Schuur Hospital

Limakatso,

Tucker,

Banda

et al. 2024

African Journal of Disability

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Background The annual incidence of lower limb amputations (LLA) at Groote Schuur Hospital is rising gradually. However, little is known about the sociodemographic and clinical profiles of people undergoing these limb amputations. Objectives To collect and analyse data to describe the sociodemographic, health and amputation profiles of people who have undergone LLA at Groote Schuur Hospital. Method A descriptive retrospective chart review was conducted using a sample of 107 participants who had undergone LLA at Groote Schuur Hospital between January 2019 and July 2020. A customised assessment tool was used to extract data on the sociodemographic, health and amputation profiles of patients who had LLA. Data were analysed descriptively. Results Sixty per cent of the patients who had undergone LLA at Groote Schuur Hospital were women. Most of the patients were over the age of 60 years and had not completed school and were pensioners or unemployed, with very low income and multiple co-morbidities including poorly controlled diabetes. Conclusions Complications because of uncontrolled diabetes were the primary indication for LLAs at Groote Schuur Hospital. Therefore, health literacy projects are indicated to address chronic diseases of lifestyle, which, in turn, may reduce the overall burden of LLA, particularly on the South African under-resourced healthcare system. Contribution The results of this study may help us identify key factors that predispose patients to LLAs. Consequently, this may help us identify key areas for prevention and better management of diseases that can result in complications that indicate the need for amputation.

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Through-knee versus above-knee amputation for vascular and non-vascular major lower limb amputations

Abstract: Through-knee versus above-knee amputation for vascular and non-vascular major lower limb amputations.

Cited by 11 publications

References 67 publications

Physiotherapy Rehabilitation for Above-Knee Amputation Secondary to Infected External Fixation: A Case Report

Physiotherapy Rehabilitation for Above-Knee Amputation Secondary to Infected External Fixation: A Case Report

Case Report: Total Knee Arthroplasty in Ipsilateral Below-Knee Amputee

The profile of people undergoing lower limb amputations at Groote Schuur Hospital

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