title: Functional results after through-knee and above-knee amputations: does more length mean better outcome?
abstract: 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.
authors.affiliation: Department of Vascular Surgery, St Antonius Hospital, Nieuwegein, Netherlands.
authors.forename: Rosemarie
authors.initials: R
authors.lastname: Met
authors.forename: Linda I
authors.initials: LI
authors.lastname: Janssen
authors.forename: Jan
authors.initials: J
authors.lastname: Wille
authors.forename: Adeline E
authors.initials: AE
authors.lastname: Langezaal
authors.forename: Rob W H
authors.initials: RW
authors.lastname: van de Mortel
authors.forename: Eric D W M
authors.initials: ED
authors.lastname: van de Pavoordt
authors.forename: Jean-Paul P M
authors.initials: JP
authors.lastname: de Vries
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical / Q000379:methods*; D001186:Artificial Limbs; D005260:Female; D006801:Humans; D007717:Knee / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000503:physiopathology / Q000534:rehabilitation / Q000601:surgery*; D020127:Recovery of Function; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D016138:Walking