Rehabilitation of patients with through-knee amputation

One hundred and one patients with through-knee amputations attending the Manchester limb-fitting centre are reviewed. Most amputations were performed for trauma or vascular disease. The interval from amputation to measurement for the first prosthesis averaged 12 weeks in cases of primary healing, and 21 weeks when healing was delayed. Artificial limbs were successfully fitted to 83%, and only 10% failed to use either a limb or a pylon. Three-quarters of those with outdoor mobility returned to work.Disarticulation through the knee has several advantages over above-knee amputation: in particular, the long end-bearing stump facilitates balance and control of the prosthesis. Disadvantages are a tendency to slow healing of the wound, lack of an internal knee mechanism in the artificial limb, and the bulky appearance of the limb. The results of rehabilitation could be improved by careful selection of patients and attention to operative detail; stump bandaging and exercises; earlier attendance at the limb-fitting centre to be measured for pylon or artificial limb; and improvements in design and production of prostheses.