Transtibial prosthesis for a patient with Kaposi's sarcoma lesions on the residual limb

A man with acquired immunodeficiency syndrome (AIDS) and widespread Kaposi's sarcoma (KS) presented with a transtibial amputation secondary to foot infection and intractable pain. Several open and draining KS lesions were present on the residual limb. There were two concerns: (1) prescribing a prosthesis to a person who likely had a limited future as a prosthetic user; and (2) how the lesions would tolerate pressure and shear forces in a prosthesis. There have been no previous reports of KS lesions of residual limbs. We prescribed a patellartendon-bearing prosthesis with supracondylar suspension. The lesions did not worsen with weight-bearing, and healed with concomitant treatment. The patient remains a functional ambulator 1 year after amputation. This case suggests that KS lesions can tolerate pressure and shear forces, which is important in considering prosthetic prescriptions as well as prescriptions of orthoses and other devices.