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Functional Results After Through-Knee and Above-Knee Amputations: Does More Length Mean Better Outcome?

Department of Vascular Surgery, St Antonius Hospital, Nieuwegein, Netherlands

Linda I. Janssen, MD

Department of Vascular Surgery, St Antonius Hospital, Nieuwegein, Netherlands

Jan Wille, MD, PhD

Department of Vascular Surgery, St Antonius Hospital, Nieuwegein, Netherlands

Adeline E. Langezaal, MD

Department of Rehabilitation Medicine, St Antonius Hospital, Nieuwegein, Netherlands

Rob W.H. van de Mortel, MD

Department of Vascular Surgery, St Antonius Hospital, Nieuwegein, Netherlands

Eric D.W.M. van de Pavoordt, MD, PhD

Department of Vascular Surgery, St Antonius Hospital, Nieuwegein, Netherlands

Jean-Paul P.M. de Vries, MD, PhD

Department of Vascular Surgery, St Antonius Hospital, Nieuwegein, Netherlands, j.vries{at}antonius.net

The objective was to evaluate our results on functional outcome for both through-knee amputations and above-knee amputations. Functional outcome was measured using the Special Interest Group in Amputee Medicine score, which focuses on walking distance and use of prosthesis. From 1997 to 2006, 39 through-knee amputations (53%) and 34 above-knee amputations (47%) were performed. Eight (21%) of 39 through-knee amputations needed to be converted to above-knee amputations. Fifty patients (24 above-knee amputations, 26 through-knee amputations) were eligible for follow-up. During follow-up, 71% (of above-knee amputations) and 69% (of through-knee amputations) did not walk with a prosthesis, and 29% of above-knee amputations and 27% of through-knee amputations walked more or less than 50 m. In conclusion, only a minority of patients is able to walk with a prosthesis, and a lot of the through-knee amputations need conversion to a higher level. On the basis of this results, it would be preferable to perform a straight above-knee amputation instead of a through-knee amputation if the correct amputation level is in doubt in high-risk patients.

Key Words: peripheral arterial disease • lower limb amputation • above-knee amputation • through-knee amputation • functional outcome

This version was published on October 1, 2008

Vascular and Endovascular Surgery, Vol. 42, No. 5, 456-461 (2008)
DOI: 10.1177/1538574408316914


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