Below knee amputation (BKA) is a surgical procedure that involves the removal of the lower limb below the knee joint. This type of amputation is typically performed to treat severe injuries, infections, or diseases that affect the lower leg, such as diabetes, peripheral artery disease, or trauma. The goal of BKA is to remove the affected tissue and promote healing, allowing the patient to regain mobility and independence. According to the Amputee Coalition of America, there are approximately 185,000 amputations performed in the United States each year, with BKA being one of the most common types of amputations.
The decision to perform a BKA is typically made after other treatment options have been exhausted, and the patient's condition has not improved. The procedure is usually performed under general anesthesia, and the surgical team will make an incision in the skin and muscle to access the affected area. The fibula and tibia bones are then cut, and the affected tissue is removed. The remaining bone is smoothed, and the skin and muscle are closed over the wound. The entire procedure can take several hours to complete, and the patient will typically require a hospital stay of several days to recover.
Types of Below Knee Amputations
There are several types of BKA, each with its own unique characteristics and indications. The most common types of BKA include:
- Trans-tibial amputation: This is the most common type of BKA, where the amputation is performed below the knee joint, but above the ankle.
- Transtarsal amputation: This type of amputation involves the removal of the foot and a portion of the lower leg.
- Chopart amputation: This is a type of amputation that involves the removal of the foot and a portion of the lower leg, but preserves the talus and calcaneus bones.
Indications for Below Knee Amputation
BKA is typically indicated for patients with severe injuries or diseases that affect the lower leg, such as:
Diabetes: Patients with diabetes are at high risk of developing foot ulcers and infections, which can lead to BKA if left untreated.
Peripheral artery disease: This condition causes narrowing of the blood vessels, which can lead to reduced blood flow to the lower leg, resulting in pain, ulcers, and infection.
Trauma: Severe injuries, such as car accidents or falls, can result in BKA if the lower leg is severely damaged.
| Condition | Number of Amputations |
|---|---|
| Diabetes | 73,000 |
| Peripheral artery disease | 45,000 |
| Trauma | 20,000 |
Post-Operative Care and Rehabilitation
After BKA, patients will require a period of recovery and rehabilitation to regain mobility and independence. The post-operative care will typically involve:
Pain management: Patients will require pain medication to manage discomfort and pain after the surgery.
Wound care: The surgical wound will need to be dressed and monitored for signs of infection or complications.
Physical therapy: Patients will require physical therapy to regain strength and mobility in the affected limb.
Prosthetic Options
After BKA, patients may be fitted with a prosthetic limb to restore mobility and independence. There are several types of prosthetic limbs available, including:
Trans-tibial prosthetic: This type of prosthetic is designed for patients with a trans-tibial amputation, and typically consists of a socket, a knee joint, and a foot.
Microprocessor-controlled prosthetic: This type of prosthetic uses advanced technology to control the movement of the prosthetic limb, providing greater stability and mobility.
What is the recovery time for below knee amputation?
+The recovery time for BKA can vary depending on the individual patient and the complexity of the procedure. Typically, patients can expect to spend several days in the hospital, followed by several weeks of recovery and rehabilitation at home.
Can I still walk and engage in physical activity after below knee amputation?
+Yes, many patients with BKA are able to walk and engage in physical activity with the use of a prosthetic limb. However, the level of mobility and activity will depend on the individual patient and the complexity of the procedure.
In conclusion, below knee amputation is a complex surgical procedure that requires careful consideration and planning. While it can be a challenging and life-altering experience for patients, advances in prosthetic technology and rehabilitation techniques have improved outcomes and quality of life for individuals with BKA. With proper care and management, patients can regain mobility and independence, and lead active and fulfilling lives.
