An above-the-knee amputation involves surgically removing part or all of the leg above the knee. It may be required due to inadequate blood flow, severe infection, trauma, tumors, or congenital disorders. The surgery involves cutting the thigh bone after tying off arteries and veins, suturing muscles and skin. Post-operative care focuses on pain management, preventing infection and swelling, and beginning physical therapy soon after to prepare for mobility with a prosthesis or wheelchair. Complications can include infection, wound issues, swelling and pain, but with treatment many patients regain mobility.

2. Above The Knee amputation (A.K.A) is the surgical removal of the leg from above the knee. transfemoral

3. Below The Knee amputation (B.K.A) is the surgical removal of the leg from below the knee transtibial

4. Parts of the Body Involved

5. Thigh Knee Calf Ankle and foot as well as surrounding muscles, veins, and tissue.

6. Reasons for Procedure

7. inadequate blood flow to the tissue of the leg Severe infection in the leg Severe trauma or irreparable injury Removal of malignant tumor Congenital disorder (eg, a limb that has not formed properly)

8. Conditions which might require an above-the-knee amputation include:

9. Peripheral vascular disease Severe injury Tumors Infection

10. Risk factors for complications include

11. Blood clotting disorder Diabetes Anemia Certain medication, such as steroids Infection Obesity

12. What to Expect

13. Prior to Procedure If the surgery is planned (versus as a result of an accident) your doctor will explain the procedure to you in detail prior to the surgery. Your doctor will also discuss with you whether you are a candidate for using a prosthesis after the surgery. If you will not be using a prosthesis, your doctor will discuss what method you will use for mobility.

14. Anesthesia You will be given general anesthesia or spinal anesthesia prior to the surgery.

15. Description of the Procedure

16. After you have been given anesthesia, and the leg has been prepared for surgery, your doctor will make a transverse incision above your knee, and locate the main artery and the veins. The muscles are cut, and the arteries and veins tied off, leaving access to the femur (the thigh bone). Using a special saw, the femur is then cut. The muscles are sutured over the bone, and then covered by the remaining flaps of skin. These skin flaps are sutured together to form the end of the stump produced by the amputation.

17. After Procedure

18. After the surgery, you will be given pain medication and antibiotics to prevent infection. Your limb will be dressed in either elastic bandages or a plaster-of-paris cast to prevent edema (swelling).

19. How Long Will It Take?

20. The length of time for this procedure will vary, depending on the condition of the patient.

21. Will It Hurt? As you will be under anesthesia, you will not feel pain during the surgery. However, you will experience pain during the postoperative period and recovery process. Your doctor will prescribe medication to alleviate the pain.

22. Possible Complications Infection Wound breakdown Swelling of the stump hip joint flexion contracture Pain Phantom limb Deep vein thrombosis

23. Postoperative Care They will ask you to move your stump frequently to help stimulate circulation, and you will begin physical therapy as soon as possible—usually within 48 hours after surgery. Initially, the stump will be swollen, and it will take several weeks for the stump to shrink.

24. Prosthesis Depending on your age, physical strength, and condition, you may be fitted with a prosthesis after the stump has shrunk. If you do receive a prosthesis, you will undergo a long-term treatment plan of physical therapy to build strength and mobility.

25. Care of the Stump

26. It is very important to keep the stump clean, dry, and free from infection at all times. If fitted with a prosthesis, you should remove it before going to sleep. Inspect and wash the stump with mild soap and warm water every night, then dry thoroughly and apply talcum powder.

27. If the skin on the stump is abraded or there is any weeping of the tissues, do not use the prosthesis until the skin has healed. The stump sock should be changed daily, and the inside of the socket may be cleaned with mild soap.

28. After the surgery… you will continue to have regular check-ups with your doctor every 3-6 months for the next two years.

29. Outcome

30. Depending upon circulation in the remaining thigh, the stump will heal after an adequate recovery period from surgery. You may use either a wheelchair or prosthesis for mobility. If you are fitted for a prosthesis, and participate in physical therapy and rehabilitation, you will be able to walk with the prosthesis.