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A mixed methods study of outcomes, experiences, and perceptions of through-knee and above-knee amputation

Crane, Hayley




Through-knee amputation (TKA) has several theoretical physical advantages over above-knee amputation (AKA), yet AKA remains the preferred level of amputation by UK vascular surgeons when below-knee amputation (BKA) is not feasible. How clinician’s perceptions of TKA influence current UK clinical practice, and how people living with TKA experience life post amputation is not currently understood.
This thesis aimed to explore the outcomes, experiences, and perceptions of TKA compared to AKA. The current qualitative evidence regarding lived experience post TKA and AKA was synthesised, and a quantitative retrospective analysis completed to compare surgical and rehabilitation outcomes. These studies showed promising outcomes for TKA from a small number of participants with TKA in the qualitative literature and dataset. Current UK practice was further explored in two studies: a descriptive, cross-sectional online survey, and a qualitative cross-sectional comparative interview study involving specialist healthcare clinicians. The similarities and differences of people living with TKA, and AKA were further explored using a qualitative cross-sectional comparative interview study.
Evidence from this thesis suggests that people with TKA have potential advantages that can improve quality of life after amputation compared to people with AKA, however barriers to communication between healthcare clinicians including a compartmentalised approach to rehabilitation and surgery threaten the quality of patient care. More evidence and training, and better collaborative working along the amputation pathway is needed to ensure that TKA is being performed for patients who would benefit from it.


Crane, H. (2022). A mixed methods study of outcomes, experiences, and perceptions of through-knee and above-knee amputation. (Thesis). University of Hull. Retrieved from

Thesis Type Thesis
Deposit Date Jun 13, 2023
Publicly Available Date Jun 13, 2023
Keywords Medical sciences
Public URL
Additional Information Hull York Medical School,
The University of Hull and University of York
Award Date Sep 1, 2022


Thesis (5.5 Mb)

Copyright Statement
© 2022 Hayley Crane. All rights reserved. No part of this publication may be reproduced without the written permission of the copyright holder.

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