Prosthetic Categories

Benefits of Delayed Below-Knee Amputation vs. Limb Salvage

    You may be trying to decide whether to undergo an amputation or to push through with limb salvage. This study, published in December 2022, may help you decide.

     Delayed below-knee amputation is more beneficial than limb salvage.

    Earlier research has found similar subjective and functional effects between individuals with delayed lower-limb amputation and limb salvage. However, these studies are typically retrospective.

    So, researchers embarked on a prospective study to determine if they can accurately predict outcomes and improve the quality of life of certain individuals.  

    The study  

    The subject participated in a fall-prevention rehabilitation training program—once before undergoing delayed below-knee amputation and again after the surgery. As part of the fall-prevention program, the study participant completed pre-training and post-training examinations, which gauged their trunk control.

    The participant went on a treadmill with obstacles meant to trip them up. This test assessed trunk control through trunk flexion—which results from a simultaneous pelvic tilt and flexion of the spine—and flexion speed. The researchers also tested the subject's trunk sway while sitting on an unstable surface.

    The researchers also administered the Four Square Step Test, which is used to evaluate dynamic stability and coordination. The test allowed them to collect data on patient-reported results, including prosthetic comfort, walking and running endurance, and pain.


    After the study, the researchers found that the participant showed improved trunk control after amputation. This was seen in the decreased trunk flexion and flexion speed after the treadmill and unstable sitting tests.

    Furthermore, the researchers found that the participant recorded shorter times on the Four Square Step Test after below-knee amputation than when they attempted to salvage it. The subject also reported greater comfort and reduced pain after amputation than during limb salvage.

    Although the study only had one participant, the researchers concluded that some individuals might benefit from delayed below-knee amputation after prolonged limb salvage. Benefits include reduced pain and restored function.