An above-the-knee amputation (AKA) is the surgical removal of the leg above the knee.
An amputation is usually done for one of the following reasons:
If an above-the-knee amputation has been recommended, your doctor will review a list of possible complications, which may include:
Some factors that increase the risk for complications include:
If your surgery is planned, your doctor will review the surgery and what to expect afterwards. Your doctor will also talk to you about how you are going to move after surgery. You may need a prosthesis (artificial limb), crutches, wheelchair, or a combination of these after surgery.
At your appointment before your surgery:
Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:
As this is major surgery that will create many life changes, many people find it helpful to receive counseling to help cope with these changes.
You may see a physical therapist who will explain your rehabilitation after surgery.
You will be asked to fast for 8-12 hours before your surgery. Ask your doctor if you should take regular medicines with a sip of water before your surgery.
You may be given:
Once you are asleep and no longer feel pain, a breathing tube will be placed if you have general anesthesia. The doctor will make an incision in the skin above the knee. Next, the muscles will be divided and the blood vessels clamped. A special saw is used to cut through the bone. The muscles are then sewn and shaped so that a stump is formed to cushion the bone. Nerves are divided and placed so they do not cause pain. The skin is closed over the muscles, forming the stump. Drains may be inserted into the stump to drain blood for the first few days after surgery. A dressing and compression stocking will be placed over the stump.
You will be taken to a recovery room. There, you will be monitored for any negative reactions. If all is well, your breathing tube will be removed while you are there. You will then be transferred to your hospital room to begin your recovery.
The length of time for this procedure will vary. The length will depend on your overall condition.
During surgery, you will not feel pain. After surgery, you will be given pain medicine in the hospital and a prescription for pain medicine to take at home. You may feel phantom pain. This is a feeling of pain in the amputated portion of the limb which is no longer present. If you do, tell your doctor so it can be treated.
The length of your hospital stay will be determined by your recovery progress and your overall health. In general, the stay may be from five days to two weeks.
While you are recovering at the hospital:
Initially, the stump will be swollen. It will take some weeks for the stump to shrink. Depending on your age, physical strength, and condition, you may be then fitted with a prosthesis. Recovery requires a long-term treatment plan of physical therapy. You will be able to walk with a prosthesis.
When you return home, do the following to help ensure a smooth recovery:
After you leave the hospital, contact your doctor if any of the following occurs:
RESOURCES:
Amputee Coalition of America
http://www.amputee-coalition.org/
National Diabetes Information Clearinghouse
http://diabetes.niddk.nih.gov/
CANADIAN RESOURCES:
Amputee Coalition of America
http://www.amputee.ca/
The War Amps
http://www.waramps.ca/
References:
Amputation. Vascular Web website. Available at: http://www.vascularweb.org/patients/NorthPoint/Amputation.html. Accessed July 21, 2009.
Leg amputation. Merck website. Available at: http://www.merck.com/mrkshared/mmg/sec3/ch29/ch29e.jsp. Accessed September 21, 2005.
Last reviewed November 2009 by Robert E. Leach, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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