Article

Dysvascularity is the main cause of lower limb amputations in
Scotland, and there is an insignificant proportion (1.7%) of knee disarticulations, despite the benefits of amputation. OBJECTIVES: The outcomes of
knee disarticulation and its associated surgical techniques will be evaluated
based on healing, reamputations, functional outcomes, prosthetic ambulation and gait biomechanics to determine whether a greater rate of knee disarticulations
can be justified among dysvascular patients.
METHODS: Key electronic databases were searched for the relevant literature based
on a pre-specified eligibility criterion. RESULTS:
The 17 articles included in
this review were appraised for their quality, and key findings are extracted.
CONCLUSION: Healing rates are favourable, but there is a need for appropriate
amputation level selection to prevent reamputations. Knee disarticulation
patients have better maintenance of independent living status than transfemoral
patients, but overall prosthetic ambulation rates are inconsistent. In terms of
gait biomechanics of knee disarticulation, there are some positive indications,
but the evidence is insubstantial. A stronger body of evidence is required in
this subject field, and recommendations are made for future research - Scottish
Intercollegiate Guidelines Network Grade of Recommendation: C. CLINICAL
RELEVANCE: This review aims to inform the multidisciplinary teams involved in the
rehabilitation of dysvascular amputees about evidence-based outcomes following
knee disarticulation. This knowledge will be beneficial when formulating
treatment pathways for this vulnerable population group.
CI - (c) The International Society for Prosthetics and Orthotics 2015.

Langue : ANGLAIS