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Exploring UK clinician perceptions of through-knee amputation compared to above-knee amputation: a mixed methods
Hayley Gordon1,2, Gemma Boam1,2, Dan Carradice1,2
1Academic Vascular Surgery Unit, Hull York Medical School, University of Hull, Hull, United Kingdom.
Through-knee amputation (TKA) offers benefits but is underused due to divided opinions and poor communication. Multidisciplinary collaboration is key to improving amputation care and decision-making.
Area of Science:
- Limb reconstruction surgery
- Amputation surgery outcomes
- Prosthetic rehabilitation
Background:
- Through-knee amputation (TKA) presents potential advantages over above-knee amputation (AKA).
- TKA is infrequently performed in the United Kingdom.
- Clinician perceptions of TKA versus AKA require exploration.
Purpose of the Study:
- To explore UK clinicians' perceptions of through-knee amputation (TKA) compared to above-knee amputation (AKA).
- To identify barriers and facilitators to the increased use of TKA.
- To understand the impact of communication on amputation pathway practices.
Main Methods:
- Mixed methods study utilizing online surveys and semi-structured interviews.
- Survey distributed to vascular surgeons, prosthetists, and physiotherapists (n=78).
- Thematic analysis of interview data (n=21) to identify key themes.
Main Results:
- Reported TKA advantages: long lever arm, femoral condyle prosthesis suspension.
- Perceived TKA disadvantages: poor wound healing, unsatisfactory prosthetic appearance.
- Ineffective communication and compartmentalized care identified as significant barriers.
Conclusions:
- Current TKA practice lacks robust evidence, relying on anecdotal information.
- Conflicting professional opinions highlight the need for multidisciplinary decision-making.
- Improved communication and pathway guidance are essential for effective amputation care.
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