Is Above or Below the Knee Amputation Better?
11/07/2006 |
Question:
Which is better, above or below the knee amputation?
Answer:
Amputation below the knee is far preferable to amputation through or above the knee. This is true even for a person who wouldn’t be doing much – or any – walking after amputation, since having an intact knee joint significantly improves mobility in the bed.
An above-knee amputee must expend considerably greater effort to walk with a prosthesis compared to a below-knee amputee walking with a prosthesis. And, despite the considerable advances which have been made in prosthetic componentry for above-knee amputees – particularly with the availability of microprocessor-controlled knee units – there really is no substitute for the structure and function of an intact knee joint.
Exceptions to the usual preference to keep the knee joint intact would include:
- if a below-knee amputation would result in too short of a residual limb to allow proper use of a below-knee prosthesis;
- if scarring or hypersensitivity of a below-knee residual limb would make use of a below-knee prosthesis unlikely;
- if there is severe arthritis or internal derangement of the knee which would be expected to result in excessive pain with weight-bearing on that knee; or
- if there is a significant knee flexion contracture – meaning the knee is unable to be straightened past a certain point – such that the advantages of a below-knee prosthetic socket couldn’t be utilized.
The specifics of each patient’s unique situation should be discussed with each patient by his/her physicians, to determine what is best for them.
For more information:
Go to the Amputation health topic.