Through-knee amputation.

Forty-three through-knee disarticulation amputations in 41 patients are reviewed. In 11 patients the procedure was entirely palliative, and 8 of these died within 1 month of operation. Of the 30 patients for whom a prosthesis was planned, only 2 died within this period. Ten patients were measured for a walking pylon preoperatively. The value of premeasurement is demonstrated by the speed of rehabilitation which was achieved by this group. The time scale of rehabilitation was much longer in those patients who were measured for their prostheses postoperatively. However, other adverse factors were present in this group, and their importance is discussed. Despite these factors, a very high rate of ultimate rehabilitation was obtained. Healing was obtained in 83 per cent of the entire series. The results indicate that the through-knee amputation is excellent for the elderly patient with atherosclerotic gangrene of the foot. The importance of an active programme of walking training in this advanced age-group is particularly stressed.