Rehabilitation after lower limb amputation: a comparative study of above-knee, through-knee and Gritti-Stokes amputations

Br J Surg. 1989 Jun;76(6):622-4. doi: 10.1002/bjs.1800760633.

Abstract

A study of 169 unilateral amputees under three Disablement Services Centres was performed. The study comprised 88 above-knee, 54 through-knee and 27 Gritti-Stokes amputations. Satisfactory rehabilitation occurred in 33 per cent of above-knee, 62 per cent of through-knee and 44 per cent of Gritti-Stokes patients (56 per cent overall). The better rehabilitation of through-knee versus above-knee amputees (P less than 0.02) was also found in a group of patients matched for comparable age and duration of amputation as well as in a group of age-matched vascular amputees. Through-knee amputees relied significantly less on wheelchairs than above-knee (P = 0.016) and Gritti-Stokes (P = 0.05) amputees. The prosthesis used for the through-knee and Gritti-Stokes amputations was considered unsightly in 50 per cent of cases (versus 31 per cent for the above-knee prosthesis). The superior rehabilitation with through-knee amputations should prompt us to improve both our technique for this amputation and the prostheses currently available. A through-knee amputation should be performed in preference to an above-knee amputation in the case where either is surgically possible, and a below-knee amputation not feasible.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Amputation, Surgical / methods
  • Amputation, Surgical / rehabilitation*
  • Artificial Limbs
  • Female
  • Humans
  • Knee
  • Leg / surgery
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care
  • Prosthesis Design
  • Time Factors
  • Wheelchairs