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Peripheral Artery Disease III: Interprofessional Care

Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
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Related Experiment Video

Updated: Jun 21, 2026

Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
09:01

Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach

Published on: January 24, 2018

Infrapopliteal lower extremity replantation.

Pedro C Cavadas1, Luis Landín, Javier Ibáñez

  • 1Valencia, Spain From Reconstructive Surgery, Clínica Cavadas.

Plastic and Reconstructive Surgery
|August 1, 2009
PubMed
Summary

Replantation of lower extremity amputations below the knee can be successful with dedicated surgical teams. This study shows a 100% survival rate and good functional outcomes in carefully selected patients.

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Area of Science:

  • Orthopedic Surgery
  • Reconstructive Surgery
  • Trauma Surgery

Background:

  • Lower extremity replantation surgery remains controversial due to historically poor outcomes.
  • Infrapopliteal (below the knee) amputations are typically discouraged.
  • This study investigates the potential indications for infrapopliteal replantation.

Purpose of the Study:

  • To evaluate the feasibility and outcomes of infrapopliteal replantation.
  • To identify key factors for successful lower limb replantation in challenging cases.

Main Methods:

  • 13 infrapopliteal amputations in 12 patients were treated with replantation.
  • Indications included intact sole and direct tibial nerve repair possibility.
  • Bone lengthening was performed in transtibial replantations; extensive tissue loss was not a contraindication.

Main Results:

  • 100% survival rate of replanted limbs.
  • High complication rate (83% soft-tissue necrosis requiring flap coverage).
  • Excellent functional outcomes (Chen grade I or II) in most patients; average treatment time 11.3 months.

Conclusions:

  • Infrapopliteal lower limb replantation can achieve satisfactory results.
  • Success is dependent on dedicated multidisciplinary teams and careful patient selection.
  • Despite high complication rates, the procedure can be a viable option.