Mobility Rates After Lower-Limb Amputation for Patients Treated with Physician-Led Collaborative Care Model

Area of Science:

• Vascular Surgery
• Amputation Management
• Prosthetic Rehabilitation

Background:

• Historically poor clinical outcomes and disorganized care for major lower-limb amputations.
• Need for physician-led, structured care pathways for patients with chronic limb-threatening ischemia and/or diabetes.

Purpose of the Study:

• To examine postamputation prosthetic mobility rates in patients treated under a physician-led collaborative care pathway.
• To describe the structure and utilization of this pathway across multiple US vascular surgery practices.

Main Methods:

• Retrospective review of 2,475 patient records from 6 vascular practices (2017-2020).
• Inclusion criteria: documented amputation surgery, prosthetic services, and mobility status.
• Analysis focused on 1,787 eligible patients undergoing 2,157 major lower-limb amputations.

Main Results:

• 62.2% of patients achieved mobility with the collaborative care pathway.
• Mobility rates varied by amputation level: 73.5% (transtibial), 40.4% (transfemoral), 35.7% (through-knee).
• Achieved mobility rates are superior or equivalent to published benchmarks.

Conclusions:

• The physician-led collaborative care pathway aligns with key global guidelines for chronic limb-threatening ischemia.
• The pathway shows potential for improving prosthetic mobility post-amputation.
• Further evaluation is recommended to confirm impact on mobility and other clinical outcomes.