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Surgical Techniques for Performing a Through-Knee Amputation: A Systematic Review and Development of an Operative
M Dewi1, B L Gwilym2, A H Coxon3
1South East Wales Vascular Network, Aneurin Bevan University Health Board, Newport, UK; Cardiff and Vale University Health Board, University Hospital of Wales, Cardiff, UK.
Annals of Vascular Surgery
|January 28, 2023
Summary
A new classification system standardizes through-knee amputation (TKA) surgical techniques. This framework aids in comparing TKA outcomes and improving future research for better patient results.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
Background:
- Through-knee amputation (TKA) offers biomechanical benefits over above-knee amputation (AKA) but faces challenges in prosthetic fit, cosmesis, and wound healing.
- Varied surgical techniques for TKA hinder comparative outcome analysis and research standardization.
- This systematic review aims to identify and classify TKA operative techniques to facilitate future research.
Approach:
- A systematic review of OVID, PubMed, and Cochrane Library databases was conducted following PRISMA guidelines.
- All papers describing TKA operative techniques were included, regardless of study design.
- Key surgical details were extracted to develop a novel classification system for TKA procedures.
Key Points:
- The review identified 28 relevant papers from 906 initial results.
- Key distinctions in TKA techniques include femur division level, patella management, gastrocnemius flap use, and skin incision type.
- A 4-component classification system (FPMS: Femur, Patella, Muscular flap, Skin incision) with shorthand nomenclature was developed.
Conclusions:
- A novel descriptive system for TKA surgical techniques has been established.
- This classification system will enhance the reporting, comparison, and interpretation of studies involving TKA.
- Standardized reporting is crucial for advancing TKA research and improving patient-centered outcomes.
