Advanced

Outcomes of a Standardized Surgical and Rehabilitation Program in Transtibial Amputation for Peripheral Vascular Disease: A Prospective Cohort Study.

Johannesson, Anton LU ; Larsson, Gert-Uno; Ramstrand, Nerrolyn; Lauge-Pedersen, Henrik LU ; Wagner, Philippe LU and Atroshi, Isam LU (2010) In American Journal of Physical Medicine & Rehabilitation 89(4). p.293-303
Abstract
Johannesson A, Larsson G-U, Ramstrand N, Lauge-Pedersen H, Wagner P, Atroshi I: Outcomes of a standardized surgical and rehabilitation program in transtibial amputation for peripheral vascular disease: A prospective cohort study. OBJECTIVE:: To study the outcomes of a new surgical and rehabilitation program for initial unilateral transtibial amputation in patients with peripheral vascular disease. The program consists of sagittal incision, rigid dressing, compression therapy using silicone liner, and direct manufacturing prosthetic technique. DESIGN:: A prospective cohort study with 1-yr follow-up. RESULTS:: Of the 217 consecutive patients with peripheral vascular disease who underwent transtibial amputation (mean age, 77 yrs; 51%... (More)
Johannesson A, Larsson G-U, Ramstrand N, Lauge-Pedersen H, Wagner P, Atroshi I: Outcomes of a standardized surgical and rehabilitation program in transtibial amputation for peripheral vascular disease: A prospective cohort study. OBJECTIVE:: To study the outcomes of a new surgical and rehabilitation program for initial unilateral transtibial amputation in patients with peripheral vascular disease. The program consists of sagittal incision, rigid dressing, compression therapy using silicone liner, and direct manufacturing prosthetic technique. DESIGN:: A prospective cohort study with 1-yr follow-up. RESULTS:: Of the 217 consecutive patients with peripheral vascular disease who underwent transtibial amputation (mean age, 77 yrs; 51% diabetic; 116 could walk before amputation), 119 (55%) were fitted with a prosthesis at a median time of 41 (range, 12-147) days after amputation. Of the prosthetic recipients, 76 (64%) obtained good function with the prosthesis within 6 mos. Within 1 yr, reamputation was performed on 8.2%, and contralateral amputation was performed on 5.5%. The 90-day mortality was 24% (53 patients). The total 1-yr mortality was 40% (86 patients): 17% among patients who received a prosthesis and 67% among those who did not receive a prosthesis or had undergone reamputation. CONCLUSIONS:: Following this standardized surgical and rehabilitation program, prosthetic fitting was achieved in more than half of transtibial amputees, almost two-thirds of prosthetic recipients obtained good function, and the reamputation rate was low. Comparison with outcomes of alternative strategies is needed. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Prosthetic, Lower Limb, Amputation, Mortality
in
American Journal of Physical Medicine & Rehabilitation
volume
89
issue
4
pages
293 - 303
publisher
Lippincott Williams & Wilkins
external identifiers
  • wos:000276726400004
  • pmid:20134308
  • scopus:77951237118
ISSN
1537-7385
DOI
10.1097/PHM.0b013e3181cf1bee
language
English
LU publication?
yes
id
01305664-fa6d-43f0-9bc2-1a60c62be23b (old id 1552935)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/20134308?dopt=Abstract
date added to LUP
2010-03-02 20:39:06
date last changed
2018-05-29 10:05:11
@article{01305664-fa6d-43f0-9bc2-1a60c62be23b,
  abstract     = {Johannesson A, Larsson G-U, Ramstrand N, Lauge-Pedersen H, Wagner P, Atroshi I: Outcomes of a standardized surgical and rehabilitation program in transtibial amputation for peripheral vascular disease: A prospective cohort study. OBJECTIVE:: To study the outcomes of a new surgical and rehabilitation program for initial unilateral transtibial amputation in patients with peripheral vascular disease. The program consists of sagittal incision, rigid dressing, compression therapy using silicone liner, and direct manufacturing prosthetic technique. DESIGN:: A prospective cohort study with 1-yr follow-up. RESULTS:: Of the 217 consecutive patients with peripheral vascular disease who underwent transtibial amputation (mean age, 77 yrs; 51% diabetic; 116 could walk before amputation), 119 (55%) were fitted with a prosthesis at a median time of 41 (range, 12-147) days after amputation. Of the prosthetic recipients, 76 (64%) obtained good function with the prosthesis within 6 mos. Within 1 yr, reamputation was performed on 8.2%, and contralateral amputation was performed on 5.5%. The 90-day mortality was 24% (53 patients). The total 1-yr mortality was 40% (86 patients): 17% among patients who received a prosthesis and 67% among those who did not receive a prosthesis or had undergone reamputation. CONCLUSIONS:: Following this standardized surgical and rehabilitation program, prosthetic fitting was achieved in more than half of transtibial amputees, almost two-thirds of prosthetic recipients obtained good function, and the reamputation rate was low. Comparison with outcomes of alternative strategies is needed.},
  author       = {Johannesson, Anton and Larsson, Gert-Uno and Ramstrand, Nerrolyn and Lauge-Pedersen, Henrik and Wagner, Philippe and Atroshi, Isam},
  issn         = {1537-7385},
  keyword      = {Prosthetic,Lower Limb,Amputation,Mortality},
  language     = {eng},
  number       = {4},
  pages        = {293--303},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {American Journal of Physical Medicine & Rehabilitation},
  title        = {Outcomes of a Standardized Surgical and Rehabilitation Program in Transtibial Amputation for Peripheral Vascular Disease: A Prospective Cohort Study.},
  url          = {http://dx.doi.org/10.1097/PHM.0b013e3181cf1bee},
  volume       = {89},
  year         = {2010},
}