Multidisciplinary Team-based Amputee Care: Level Sparing Surgical Techniques and Treatment of Chronic Pain

Abstract

Careful consideration of a multitude of factors including vascular status, soft tissue envelope, functional status, and goals are integral in determining optimal amputation technique. For patients undergoing a secondary or revision amputation, those same factors, in addition to frequently encountered issues such as poor prosthetic fit, unstable soft tissues, neuromatous pain, and poor overall function should be evaluated. A multidisciplinary team including orthopedics, musculoskeletal radiology, plastic and reconstructive surgery, vascular interventionists, infectious disease, physical medicine and rehabilitation specialists, wound care, physical therapy, and prosthetists are integral to the optimal care of amputees and the potential for level sparing amputation surgery. Ample social support including social work and an amputee support group is fundamental in helping patients navigate primary amputation issues as well as the transitions over time as an amputee learns to live their life optimally.