title: Knee disarticulation: survival, wound healing and ambulation. A historic cohort study.
abstract: The aim of this study was to analyze survival, wound healing and ambulation after knee disarticulation (KD). A historic cohort study using medical records and nursing home records was performed. Data included demographics, reason for amputation, concomitant diseases, survival, wound healing, re-amputation and ambulation. Data of 80 patients (71 unilateral and nine bilateral amputees) were available for evaluation. Median follow-up was 9.9 years (IQR: 4.1; 14.3 years). Mean age of amputation was 76.9 (+/- 9.6) years. Reason for amputation was gangrene in 72 patients. Most common concomitant (96%) disease was peripheral arterial disease (PAD). Survival after 1, 6 and 12 months was 87%, 65% and 52%, respectively. Delayed wound healing occurred in 42% (n = 16) of the patients with two or three concomitant diseases and in 15% (n = 6) of the patients with no or one concomitant disease. Trans-femoral re-amputation was performed in nine (12%) patients. Of the 61 discharged KD amputees, 36 (59%) were provided with a prosthesis. Eventually 21 (34%) patients became household walkers.
authors.affiliation: Medical Student, University of Groningen, The Netherlands.
authors.forename: K
authors.initials: K
authors.lastname: Ten Duis
authors.forename: J C
authors.initials: JC
authors.lastname: Bosmans
authors.forename: H G J
authors.initials: HG
authors.lastname: Voesten
authors.forename: J H B
authors.initials: JH
authors.lastname: Geertzen
authors.forename: P U
authors.initials: PU
authors.lastname: Dijkstra
mesh_terms: D000368:Aged; D000671:Amputation, Surgical / Q000401:mortality; D000674:Amputees; D015331:Cohort Studies; D003286:Contracture / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005734:Gangrene / Q000601:surgery; D006801:Humans; D007239:Infections / Q000601:surgery; D007717:Knee / Q000601:surgery*; D008297:Male; D009983:Orthopedic Equipment; D016491:Peripheral Vascular Diseases / Q000601:surgery; D016019:Survival Analysis; D016138:Walking; D014910:Wheelchairs; D014945:Wound Healing