[Knee joint exarticulation in arterial occlusive disorders of the lower extremity]

In 35 patients suffering from peripheral ischemic disease of the legs, disarticulation of the knee joint was performed instead of above-knee amputation. Operations were executed primarily or after failed bypass procedures for the salvation of the limb. 24 cases (67%) showed primary or delayed secondary stump healing. In 11 cases (31%), however, no stump healing was achieved due to either a wound infection (4 cases) or a necrosis of the anterior flap covering the weight bearing area of the stump (7 cases). Factors influencing the outcome of stump healing are discussed and different techniques of knee disarticulation are evaluated as to their benefits and disadvantages in ischemic limbs. As the method offers several advantages over above-knee amputation, a more frequent use of knee disarticulation in the surgical treatment of ischemic legs which cannot be preserved by other surgical measures and usually would be amputated at above-knee level is recommended.