Through-knee amputation in peripheral vascular disease

Abstract

Through-knee amputation accounts for just 2.8% of annual amputations in England. Traditionally it is viewed as an operation with poor outcomes, and its use limited. We present a case series and review of articles published on through knee amputation. The literature review covers the 17 papers identified on through-knee amputation in peripheral vascular disease. The results are summarised and discussed, with favourable outcomes in terms of perioperative mortality and primary healing demonstrated in the majority of papers. In the case series, 14 patients who underwent through knee amputation were retrospectively reviewed. Peri- operative mortality was 7%. Primary healing was achieved in 79% of cases. Functional outcomes were excellent, with predicted functional activity achieved in 81% of survivors, with 34% ambulating regularly. In conclusion, through-knee amputation should be considered as an alternative to transfemoral amputation, as perioperative mortality, healing rates and functional outcomes appear excellent, both in this series and the majority of others published.