Transtibial (Below-the-Knee) Amputation

What are Transtibial (Below-the-Knee) Amputations?

Transtibial amputations, also referred to as ‘below-the-knee’ or ‘BKA’ amputations, are some of the most commonly performed of the major limb amputations.

About half of all major lower-limb amputations are transtibial. Because of this, and the advances made in medical technology over the years, many individuals with transtibial amputations are able to successfully complete physical rehabilitation.

 

 

Transtibial (Below-the-Knee) Amputation 

A below-the-knee amputation is performed when a patient becomes severely injured or develops a life-threatening infection. Other reasons include chronic pain, birth defects, tumors, and non-healing ulcers. The decision to amputate involves many factors and is done after a thorough discussion between patient and orthopaedic surgeon.

Transtibial amputation allows the amputee to keep their knee joint, which is a huge benefit. If possible, the surgeon will attempt to preserve a healthy knee joint because they’re beneficial to balance, as well as maintaining the ability to lift and lower oneself. Knees also allow us to slow down, walk on stairs and slopes, and push forward. A prosthetic knee provides the bending ability of a knee, but not the power, since a prosthetic knee is basically a swinging hinge.

There are two major bones in the lower leg that the surgeon considers when performing a transtibial amputation. The larger of the two leg bones is the tibia, the smaller is the fibular. These bones are joined at the top and bottom by joints at the knee and ankle. When these bones are surgically divided in transtibial amputation, they maintain their joining near the knee, but not below. 

 

 

FAQ from the American Orthopedic Foot & Ankle Society

 

What kind of activities can I expect to be able to do?

This depends on your level of activity before surgery. Patients are often able to return to the level of activity they had prior to amputation. An amputation may even allow a higher level of activity such as brisk walking or even running. Younger patients without other medical problems or joint ailments may have the best results.

 

What are the keys to having a good outcome?

Knowing what to expect is important. Even a perfectly performed surgery may be seen as a failure if a patient has the wrong expectations. This is one of the reasons why it is important to learn about the procedure and talk to as many patients and practitioners as possible before the operation. Speaking with a patient who is of similar age and has undergone an amputation for similar reasons can be extremely helpful.

 

What can I do before surgery to stay strong?

Prior to your operation it is important to maintain hip and knee strength. This can be accomplished with straight leg raises and knee extension exercises. These exercises should be continued during your recovery.

 

What kinds of things can help healing?

It is important to protect the limb and incision after surgery. If you are given a brace or cast to wear, you should wear this exactly as directed. It takes only one accidental bump to open the incision. If this happens, it could delay healing by several weeks or even months. It may even require additional surgery.

If you are a smoker, you should stop. Smoking has been associated with numerous complications. These include wound healing problems, bone healing problems, heart and lung disease, pain and even arthritis. The risks of surgery are sometimes so high that some surgeons will hold off on performing an amputation until a patient has stopped smoking entirely. Proper nutrition and medical management of chronic disease, particularly diabetes, is also helpful.

 

 

Remember…

Recovery is an ongoing process, and varies from person to person. There are several phases on the road to recovery, and each can hold difficult challenges and require different coping strategies. Many people feel that talking with friends and family (or a counselor) can help ease emotional distress. 

Patients undergoing amputation will need help in dealing with the changes in body image as they adjust to the loss of a limb. They should be encouraged and given the opportunity to express feelings of anxiety, grief, anger, and depression, and given guidance in working toward a healthy acceptance of their handicap.

About Kenney Orthopedics…

Working closely with patients and caregivers in Kentucky and Indiana, the Kenney Orthopedics Team employs the latest biomechanical management, materials, and technology to restore function and permit normal motion after your amputation. Our highly qualified staff in our Kentucky and Indiana locations will select, design, and fabricate the appropriate prostheses, prosthetic, or orthosis to fit your specific lifestyle and needs. Please contact us, or visit us at one of our many locations in Kentucky or Indiana if you have any questions! 

Working closely with patients and caregivers in Kentucky and Indiana, the Kenney Orthopedics Team employs the latest biomechanical management, materials, and technology to restore function and permit normal motion after your amputation.

The highly qualified staff of Kenney Orthopedics will select, design, and fabricate the appropriate prostheses, prosthetic limb or device, or orthosis to fit your specific lifestyle and needs after your amputation. Visit us in Louisville or Lexington, Kentucky, or at one of our other locations in Kentucky (KY) or Indiana (IN). We can help you get moving again with a prosthesis designed for you after your amputation!

 

Sources: 1, 2, 3, 4, 5, 6, 7, 8

 

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