BACKGROUND: Nonhealing below-knee amputation (BKA) necessitates redo BKA or conversion to above-knee amputation (AKA). Outcomes after redo BKA remain poorly defined. We hypothesized that in selected patients redo BKA results in favorable functional outcomes. METHODS: Patients undergoing redo BKA at a single institution during 4 years were reviewed. A concurrent cohort proceeding directly to ipsilateral AKA served as comparative controls. RESULTS: Of 138 BKAs, 23 (17%) failed to heal primarily. Baseline demographics and medical comorbidities were similar between groups. Clinicians selected 14 for redo BKA and 9 for ipsilateral AKA. Eight (57%) of those undergoing redo BKA had a history of minor stump trauma and 13 (93%) had a palpable popliteal pulse, compared with no trauma (P = 0.007) and 4 (44%, P = 0.018) palpable popliteal pulses in the AKA group. Functionally, 86% of redo-BKA patients returned home, all eventually healed, and 86% walked, whereas none in the AKA group walked. CONCLUSIONS: In selected patients, redo BKA yields excellent functional outcomes. A history of minor stump trauma and a palpable popliteal pulse favor redo BKA compared with conversion to AKA.
BACKGROUND: Nonhealing below-knee amputation (BKA) necessitates redo BKA or conversion to above-knee amputation (AKA). Outcomes after redo BKA remain poorly defined. We hypothesized that in selected patients redo BKA results in favorable functional outcomes. METHODS:Patients undergoing redo BKA at a single institution during 4 years were reviewed. A concurrent cohort proceeding directly to ipsilateral AKA served as comparative controls. RESULTS: Of 138 BKAs, 23 (17%) failed to heal primarily. Baseline demographics and medical comorbidities were similar between groups. Clinicians selected 14 for redo BKA and 9 for ipsilateral AKA. Eight (57%) of those undergoing redo BKA had a history of minor stump trauma and 13 (93%) had a palpable popliteal pulse, compared with no trauma (P = 0.007) and 4 (44%, P = 0.018) palpable popliteal pulses in the AKA group. Functionally, 86% of redo-BKApatients returned home, all eventually healed, and 86% walked, whereas none in the AKA group walked. CONCLUSIONS: In selected patients, redo BKA yields excellent functional outcomes. A history of minor stump trauma and a palpable popliteal pulse favor redo BKA compared with conversion to AKA.
Authors: S A Berceli; A K Chan; F B Pomposelli; G W Gibbons; D R Campbell; C M Akbari; D T Brophy; F W LoGerfo Journal: J Vasc Surg Date: 1999-09 Impact factor: 4.268
Authors: Spence M Taylor; Corey A Kalbaugh; Dawn W Blackhurst; Steven E Hamontree; David L Cull; Hayley S Messich; R Todd Robertson; Eugene M Langan; John W York; Christopher G Carsten; Bruce A Snyder; Mark R Jackson; Jerry R Youkey Journal: J Vasc Surg Date: 2005-08 Impact factor: 4.268
Authors: Mark R Nehler; Joseph R Coll; William R Hiatt; Judith G Regensteiner; Gabriel T Schnickel; William A Klenke; Pam K Strecker; Michelle W Anderson; Darrell N Jones; Thomas A Whitehill; Shevie Moskowitz; William C Krupski Journal: J Vasc Surg Date: 2003-07 Impact factor: 4.268