Below Knee Amputation: Surgery, Recovery and Maintaining Mobility
There are 1.8 million people living with amputations, and between 30,000 and 40,000 amputations performed on an annual basis in the United States . Below knee amputations are the most common amputation surgery and comprise about 23 percent of lower limb amputation surgeries. The majority of below knee amputations are performed on individuals 65 and older.
Any form of amputation is a life-changing event, but it’s important to remember that amputations are viewed as a reconstruction surgery with the goal of returning the patient to a normal life. Advances in medical technology and prosthetics have helped many patients return to a relatively pain-free and active lifestyle after amputation surgery.
Causes of Below Knee Amputations
Below knee amputation surgery is generally performed if a person’s lower extremity or foot has been severely injured or if he or she suffers from chronic and sever pain in the foot or lower extremity. Causes are generally related to the following:
- Trauma – A severe injury resulting from an event such as a vehicle accident or serious burn that causes severe fractures and/or nerve injuries.
- Diabetes – People who suffer from diabetes may experience poor circulation because their arteries. This is known as peripheral vascular disease (PVD). In this case, poor circulation does not allow the impacted extremities to obtain sufficient nutrients and oxygen. The affected tissue begins to deteriorate, which can lead to amputation. PVD is the leading cause of below knee amputations.
- Cancer – Untreatable tumors in the bone or muscle of a lower limb may lead to below knee amputation.
- Infections – If infections are untreatable with antibiotics or other medical remedies, removal of the lower limb may be required.
- Neuroma – Thickening of nerve tissue is called Neuroma, a condition that can cause severe pain. Neuroma most often affects feet.
- Congenital Limb Deficiency – A common cause of below knee amputation among small children, Congenital Limb Deficiency takes place when a limb does not form completely.
- Complex Regional Pain Syndrome (CRPS) – A chronic pain condition that usually affects the extremities, CRPS is typically caused by an injury or trauma. CRPS is a complicated condition that’s believed to be caused by damage to the peripheral or central nervous system.
While there are many additional reasons a person may choose below knee amputation, those listed above are most common .
Below knee amputation surgery is a serious undertaking aimed at resolving complicated or life-threatening issues in the foot or other parts of the leg below the knee. Any decision to amputate involves multiple factors and should include many discussions between the patient and their team of doctors..
Tips for Successful BK Amputation
Below knee amputation surgery is a means to improve the quality of life for many patients. There are a number of actions you can take to prepare for the surgery and facilitate your transition to an independent and, hopefully, pain-free lifestyle.
Know what to expect
Talk to your medical care team about how to prepare for surgery and what to expect from rehabilitation. Consult your primary care physician, orthopedic surgeon, prosthetist (a specialist in the design and fit of prosthetic limbs), physical therapist and rehabilitation doctor. You may also want to discuss the surgery with a psychologist, psychiatrist, social worker or another person who has already undergone below knee amputation.
Seek out a below knee amputee who is similar in age to learn what they did to make their surgery and rehabilitation successful. Find and get involved with support groups to help answer questions about the physical and psychological effects of amputation and tips about how to return to your ideal lifestyle.
Familiarize yourself with the transition to a prosthetic and seek out methods to ease that transition. (A list of support and peer groups is included at the end of this article.)
Also, begin to think about changes you’ll need to make at home. If you’ll be confined to a wheelchair for a period of time you might need to install ramps that go around or over stairs. Think about methods that will help you transition to an independent lifestyle following surgery. You may want to reposition furniture, kitchen items and other frequently-used household items to make them more accessible.
Get involved with the BKA community (blogs, YouTube, Facebook pages and support groups), and learn tips and tricks that will make your transition following surgery more comfortable.
Stay strong and healthy
Below knee amputees use approximately 25 percent more energy to walk following a BTK amputation , so it’s extremely important to maintain or increase your strength and overall fitness before surgery. Many doctors will prescribe exercises to maintain muscle conditioning in the upper leg and improve strength and flexibility in the hip and knee. Straight leg raises and knee extension exercises should be performed regularly before surgery.
Some below knee amputees have said learning to walk with a walker, crutches, knee scooter or a device like iWALK hands-free crutch helped them tremendously following surgery. Learning to balance while not bearing weight on one leg can be challenging, and it may take time to adjust.
Advances in medical device technology, such as with the iWALK hands-free crutch, have enabled many BKA patients to learn to walk with a prosthetic even before amputation surgery and have eased the transition to life with a prosthetic foot or prosthetic leg. Using this technology not only helps patients maintain muscle strength before surgery, but has also shown to smooth the transition to using a prosthetic leg.
Maintaining a healthy diet and proper nutrition before surgery is also important. Your body needs nutrients to maintain muscle mass and heal properly. Exercise is important, but a healthy diet can eliminate weight gain and prepare your body for a quick recovery and successful rehabilitation.