Knee disarticulation: survival, wound healing and ambulation. A historic cohort study

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.