An above-the-knee amputation (AKA) is the surgical removal of the leg above the knee.
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An amputation above the knee may be done because of: Poor blood flow that cannot be fixedSevere infectionTrauma
TumorsCongenital disorders, such as a limb that has not formed properly
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like: Skin breakdown at the residual limbInfectionPoor healing of the amputation site that may require a higher level amputationSwelling of the residual limbDecreased range of motion in the hip jointPhantom limb sensation
—feeling that the amputated limb is still there
—feeling pain in amputated limb area
BleedingBlood clotsReaction to anesthesia
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as: SmokingDrinking
Chronic diseases, such as
Your doctor may do the following before your procedure: Physical examBlood tests
Imaging tests, such as
Have you donate blood in case you need a transfusionPrescribe antibiotics to prevent infection
Before surgery, you will need to: Arrange for a ride home.Arrange for help at home while you recover.Talk to your doctor about any medications, herbs, or supplements you are taking.
Ask your doctor about devices you will need after the surgery like an artificial limb,
Talk to the doctor about the medications you are taking. You may need to stop taking some medications up to 1 week before the procedure.
Do not eat or drink anything after midnight the day before your surgery, unless told otherwise by your doctor.
An incision will be made 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.
Several hours, depending on your health and the reason for the surgery
Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
The usual length of stay is 5-14 days. It is possible that you may have to stay longer if complications arise. You may also go to a rehabilitation hospital to help you recover.
Right after the procedure, you will be in a recovery room where your blood pressure, pulse, and breathing will be monitored. Recovery may also include: Pain medicationsAntibiotics to prevent infectionMedication to prevent blood clots
Physical therapy often starts within 24 hours after your surgery. During this time you may need devices to help you walk.
During your stay, the hospital staff will take steps to reduce your chance of infection, such as: Washing their handsWearing gloves or masksKeeping your incisions covered
There are also steps you can take to reduce your chance of infection, such as: Washing your hands often and reminding your healthcare providers to do the sameReminding your healthcare providers to wear gloves or masksNot allowing others to touch your incision
When you return home, take these steps: Continue with your physical therapist’s exercise program.Be sure to follow your doctor's instructions.
Adjusting to an amputation may be difficult and can lead to
. Consider talking to a therapist or psychologist.
Call your doctor if any of these occur: Increased swelling in the residual limbPoorly fitting prosthesisPain that can't be controlled with the medications you've been givenSigns of infection, such as fever or chillsIncreasing redness, swelling, increasing pain, excess bleeding, or discharge from the incision sitePersistent nausea or vomitingIncreased symptoms of depression
, shortness of breath, or chest pain
Joint pain, fatigue, stiffness, rash, or other new symptoms
If you think you have an emergency, call for emergency medical services right away.
Amputation. John Hopkins Medicine website. Available at: http://www.hopkinsmedicine.org/healthlibrary/conditions/adult/physical_medicine_and_rehabilitation/amputation_85,P01141. Accessed December 4, 2014.
Amputation. Society for Vascular Surgery website. Available at:
http://www.vascularweb.org/vascularhealth/Pages/amputation.aspx. Updated February 2011. Accessed December 4, 2014.
Amputation procedure. John Hopkins Medicine website. Available at: http://www.hopkinsmedicine.org/healthlibrary/test_procedures/cardiovascular/amputation_procedure_92,P08292. Accessed December 4, 2014.
Management of critical limb ischemia. EBSCO DynaMed website. Available at:: http://www.ebscohost.com/dynamed. Updated July 16, 2014. Accessed December 4, 2014.
Last reviewed December 2014 by Michael Woods, 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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