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Related Experiment Videos

Changing pattern of lower limb amputation for vascular disease.

K K Sethia, A R Berry, J D Morrison

    The British Journal of Surgery
    |September 1, 1986
    PubMed
    Summary

    Lower limb amputation rates increased by 33% in six years. Injudicious arterial reconstruction before amputation may hinder rehabilitation outcomes.

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    Area of Science:

    • Vascular Surgery
    • Orthopedic Surgery
    • Rehabilitation Medicine

    Background:

    • A previous review reported lower limb amputation data from 1974-1978.
    • Recent data shows a 33% increase in lower limb amputations for peripheral vascular disease over six years.
    • This rise exceeds that attributable to population aging alone.

    Purpose of the Study:

    • To analyze trends in lower limb amputation rates and types.
    • To evaluate the impact of reconstructive vascular surgery on amputation levels and rehabilitation.
    • To identify factors influencing re-amputation and successful prosthetic limb use.

    Main Methods:

    • Retrospective analysis of 193 lower limb amputations for peripheral vascular disease.
    • Comparison of amputation types: below-knee amputation (BKA) versus Gritti-Strokes amputation (GSA).

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  • Assessment of re-amputation rates, reasons, and subsequent rehabilitation success.

    • Main Results:

    • Amputation rate increased by 33% over six years.
    • Fewer BKAs (33%) and more GSAs (32%) were performed.
    • Overall re-amputation incidence was 13.5%. BKA stumps had a 28% re-amputation rate with 75% successful rehabilitation, while GSA stumps had an 8% re-amputation rate with 28% successful rehabilitation.
    • 37% of patients had prior reconstructive vascular surgery.
    • 58% of patients requiring re-amputation had undergone arterial reconstruction, often shortly before amputation (26.9%).

    Conclusions:

    • The increase in lower limb amputations is significant and not solely due to an aging population.
    • Changes in amputation technique (fewer BKA, more GSA) and high re-amputation rates impact rehabilitation.
    • Injudicious arterial reconstruction attempts prior to inevitable amputation may negatively affect outcomes and jeopardize rehabilitation.