AB - Background: Prior studies have identified age as a factor in determining an individual's likelihood of receiving a prosthesis following a lower limb amputation. These studies are limited to specific subsets of the general population and are unable to account for preamputation characteristics within their study populations. Our study seeks to determine the effect of preamputation characteristics on the probability of receiving a prosthesis for the general population in the United States. Objective: To identify preamputation characteristics that predict of the likelihood of receiving a prosthesis following an above-knee amputation. Design: A retrospective, population-based cohort study. Setting: Olmsted County, Minnesota (2010 population: 144,248). Participants: Individuals (n = 93) over the age of 18 years who underwent an above-knee amputation, that is, knee disarticulation or transfemoral amputation, while residing in Olmsted County, MN, between 1987 and 2013. Methods: Characteristics affecting the receipt of a prosthesis were analyzed using a logistic regression and a random forest algorithm for classification trees. Preamputation characteristics included age, gender, amputation etiology, year of amputation, mobility, cognitive ability, comorbidities, and time between surgery and the prosthesis decision. Main Outcome Measures: The association of preamputation characteristics with the receipt of a prosthesis following an above-knee amputation. Results: Twenty-four of the participants received a prosthesis. The odds of receiving a prosthesis were almost 30 times higher in those able to walk independently prior to an amputation relative to those who could not walk independently. A 10-year increase in age was associated with a 53.8% decrease in the likelihood of being fit for a prosthesis (odds ratio = 0.462, P =.030). Time elapsed between surgery and the prosthesis decision was associated with a rise in probability of receiving a prosthesis for the first 3 months in the random forest algorithm. No other observed characteristics were associated with receipt of a prosthesis. Conclusions: The association of preamputation mobility and age with the likelihood of being fit for a prosthesis is well understood. The effect of age, after controlling for confounders, still persists and is associated with the likelihood of being fit for a prosthesis.
Above-the-knee amputation (AKA) is a last-resort surgical option for the treatment of periprosthetic joint infection (PJI) with resistant organisms or with recurrent infections. Certain circumstances are unique to performing AKAs after total knee arthroplasty (TKA). When performing an AKA, the factors that require special attention include the indications for surgery, presentation and comorbidities, level of amputation, possible prosthesis removal, and potential complications. This chapter includes a discussion of the surgical techniques, postoperative stump care, options for prostheses, functional status, and long term follow up after AKA. This chapter provides comprehensive and relevant information for assessing, performing, and treating AKA patients after infected TKAs.
Amputee putting on above knee prosthesis - YouTube
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Above Knee Amputation (AK) | McCleve O&P
Determining the most effective type of amputation for each patient (e.g., above knee vs. below knee, above knee vs. knee disarticulation) can be critical in achieving an optimal residual limb length for a properly fitting prosthesis. Next Step clinicians offer free consultation services to surgeons before surgery to discuss ways to maximize a patient's prosthetic potential and to determine the optimal location of the amputation.
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At McCleve O&P, we believe in a team approach to your below knee amputation and prosthetic care. We team with doctors, wound clinics, and rehabilitation centers across the state and country to assure you receive the very best care possible. Losing a limb is a traumatic experience and will require focus and teamwork to help you regain the mobility and quality of life you deserve.