Amputation: Below the Knee

General Information

Amputation is defined as removal of part of any or part of a limb or appendage of the body. A below the knee amputation is also called a trans-tibial amputation or BKA amputation. The residual part of the limb that remains after the procedure is often called a stump. Your orthopaedic surgeon will retain the knee joint and save as much of the lower limb as possible and maintain the best measurement of stump length for optimal prosthetic fit and circulation.

Reasons for Amputation

• Poor peripheral circulation, sometimes caused by diabetes
• Hardening of the arteries or atherosclerosis, a condition caused by thickening of artery walls
• Infection or gangrene
• Frostbite
• Traumatic accidents
• Damaged blood vessels

Diagnosis

In order to confirm that an amputation is necessary, you may undergo a number of tests that may include:

• Blood and culture studies
• x-rays
• Angiogram - to check blood flow in your leg
• Arterial Doppler imaging or arteriography studies

Surgery

You will be placed under general anesthesia during the surgical procedure so you'll be asleep. Then:

• A circular incision will be made in the skin and muscular tissues above the knee
• Blood vessels, nerves and femur (thighbone) are severed. Blood vessels are tied off.
• The bone end is covered with a "flap" - often created with your own skin, muscle or other connective tissue
• Muscles are stitched together with large sutures
• The skin is closed with small sutures
• The stump is wrapped in a thick bandage - your bandage may be a hard cast or soft, depending on the condition of your leg upon amputation. If you had infection, a soft bandage is most often used, covered with an elastic bandage.

What to Expect

Your doctor may suggest that an artificial limb or prosthesis be fitted to your stump as soon as possible to aid in the recovery process. You can expect to stay in the hospital for 2 to 7 days, with an approximately six-week recovery period following the surgical procedure. You will undergo physical rehabilitation to help with gait training and to aid in your adaption of a prosthetic device for greater independence and mobility.