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Amputation

Elective below the knee amputation

09/17/2008

Question:

I had an accident when I was 18. I am 39 now. I have constant pain in my knee and ankle. The only options I am given right now are to have complete recontructive surgery on my ankle and a complet knee replacement. My quetion is this... I would like to have my leg amputated because I think in the long run I would be better off considering my age. With just the reconstructive and replacement surgey I am guessing that i will end up having worse artritis than I have now, and will have to keep having knee surgerys every 10 years. And the biggest thing in my mind is I could probably run with my 6 year old son if I have a prostheses. I am a healthy, well, fit man, except my leg of course, so I really think amputation is the way to go. What do you think?

Answer:

If you were to proceed with an above-knee amputation, you may or may not become capable of running with a prosthesis (assuming there are no complications from an amputation surgery, your postoperative recovery and rehabilitation proceed smoothly, and your residual limb becomes capable of tolerating forces such as those associated with running), depending on the choice of prosthetic componentry (FYI, the newer, sophisticated microprocessor-controlled knee units are not designed for running), your overall physical condition, the condition of your opposite leg and lower back, and your body weight, among other considerations.

Prior to undergoing such surgical interventions as ankle reconstruction or knee replacement, nonsurgical treatment options should ideally have been exhausted and without sufficient benefit. You may consider verifying this is, indeed, the case by getting additional opinions, if you've not already done so, from another orthopedist (who performs amputation surgery as part of their practice), but also from a physical medicine and rehabilitation physician, as well as a prosthetist, and ideally, also, one or more active above-knee amputees around your age. A team approach to assist with making such a serious and irreversible decision is always preferable.

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Response by:

Brian L Bowyer, MD Brian L Bowyer, MD
Clinical Associate Professor
Physical Medicine & Rehabilitation
College of Medicine
The Ohio State University