Rehabilitation after lower limb amputation: A comparative study of above-knee, through-knee and Gritti—Stokes amputations

Abstract

A study of 169 unilateral amputees under three Disablement Services Centres was performed. The study comprised 88 above‐knee, 54 through‐knee and 27 Gritti‐Stokes amputations. Satisfactory rehabilitation occurred in 33 per cent of above‐knee, 62 per cent of through‐knee and 44 per cent of Gritti—Stokes patients (56 per cent overall). The better rehabilitation of through‐knee versus above‐knee amputees (P<0·02) was also found in a group of patients matched for comparable age and duration of amputation as well as in a group of age‐matched vascular amputees. Through‐knee amputees relied significantly less on wheelchairs than above‐knee (P = 0·016) and Gritti—Stokes (P = 0·05) amputees. The prosthesis used for the through‐knee and Gritti—Stokes amputations was considered unsightly in 50 per cent of cases (versus 31 per cent for the above‐knee prosthesis). The superior rehabilitation with through‐knee amputations should prompt us to improve both our technique for this amputation and the prostheses currently available. A through‐knee amputation should be performed in preference to an above‐knee amputation in the case where either is surgically possible, and a below‐knee amputation not feasible.