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Through knee amputation: technique modifications and surgical outcomes.

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Area of Science:

  • Orthopedic Surgery
  • Reconstructive Surgery
  • Amputation Surgery

Background:

  • Knee disarticulations (KD) are rare lower extremity amputations, typically for trauma or tumors.
  • KDs offer benefits like proprioception, a long lever arm, and an end-bearing stump.
  • The efficacy of KDs for arterial insufficiency or infection is less understood.

Purpose of the Study:

  • To describe technique modifications for knee disarticulations (KD).
  • To report surgical outcomes of KDs at a high-volume Limb Salvage Center.

Main Methods:

  • Retrospective review of medical records for patients undergoing through-knee amputation (2004-2012).
  • Data collected included demographics, operative details, and postoperative outcomes.

Main Results:

  • 46 KDs were performed on 41 patients (mean age 68).
  • Indications: infection (56%), arterial thrombosis (35%), trauma (9%).
  • Complications included cellulitis (13%), infection (4%), flap ischemia (4%). 22% achieved ambulation, higher in trauma and younger patients. Diabetes and infection decreased ambulation likelihood.

Conclusions:

  • Knee disarticulations are a safe and effective alternative amputation when feasible.
  • KD maximizes transfers and mobility for non-ambulatory patients, preventing knee flexion contractures.