Comparing Outcomes of Through knee and Above knee Amputation

Project Description

Project aims: To explore quality of life and rehabilitation outcomes for through knee (TK) amputees and above knee (AK) amputees.

TK amputation is rarely performed despite documented functional benefits and reports that surgical outcomes for dysvascular TK and AK amputees are comparable. A recent systematic review of TK outcomes found no studies investigating quality of life outcomes for this patient population and there is no literature exploring patient or professional views of this procedure. Comparative rehabilitation outcomes between groups is equally poorly documented.

Mixed methods including questionnaires, semi-structured interviews and focus groups recruiting from two artificial limb centres will be used. Opinions of TK and AK will be gathered from amputees and relevant health professionals including physiotherapists, prosthetists and vascular surgeons. The questionnaire results will inform the topic guide and questions for the face to face semi-structured interviews. Focus groups will then be conducted to ensure that all developed themes have been fully investigated. Thematic analysis will compare and contrast the data for TK and AK groups. SPARG data for TK and AK will be analysed with regard to rehabilitation outcomes.

If quality of life and functional outcomes are worse with TK amputation this could support current practice of preferentially performing AK amputation. If results are similar or better this would recommend the design of a multi-centre randomised controlled trial comparing interventions and post-op rehabilitation outcomes for TK and AK amputees.