Eric Neufeld, CPO, FAAOP, and Joshua Parry, MD, an orthopedic surgeon, surveyed prosthetists about their experiences treating patients with knee disarticulations and transfemoral amputations to guide decision-making for patients and surgeons.
A blinded electronic mail survey was completed by 102 prosthetists who were asked if they preferred to treat knee disarticulation or transfemoral amputations and why; which amputation level they believed patients preferred and why; and common problematic issues between the types of amputation.
The data indicated no consensus among the respondents.
Fifty-four prosthetists (53 percent) preferred knee disarticulation and 48 (47 percent) preferred transfemoral amputation. Fifty-five prosthetists (54 percent) believed patients preferred transfemoral amputations and 47 (46 percent) believed patients preferred knee disarticulation. Amputation level preference often depended on age, functional goals, and concerns with cosmesis.
The most common benefits given for knee disarticulation over transfemoral amputations included distal end weight bearing, a lower subischial socket, and better function. The most common disadvantages given for knee disarticulation over transfemoral amputation included component limitations due to space available below amputation, poor cosmesis, an asymmetrical knee axis, and difficulties with sitting/standing.
The study, “Knee disarticulation Versus Transfemoral Amputation: The Prosthetist’s Perspective,” was published in the Journal of Orthopaedic Trauma.