Patricia Griffin Kellicker, BSN
A below-the-knee amputation (BKA) is the surgical removal of the leg below the knee.
An amputation below the knee may be done because of:
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
Factors that may increase your risk of complications include:
Your doctor may do the following before your procedure:
Before surgery, you will need to:
You may need to stop taking some medications up to one week before the procedure. Medications that may need to be stopped may include:
Do not eat or drink anything after midnight the day before your surgery, unless told otherwise by your doctor.
You may be given either:
The doctor will make a cut in the skin below the knee. The muscles will be separated and blood vessels clamped. A special saw will be used to cut through the bone. The muscles will be sewn and shaped so that a stump is formed to cushion the bone. Nerves will be separated and placed so that they do not cause pain. Blood vessels will be tied off. The skin will be closed over the muscles, forming the stump. Drains may be inserted into the stump to drain blood for the first few days. A dressing and compression stocking will be placed over the stump.
Several hours, depending on your health and the reason for the surgery
Anesthesia will block pain during the procedure. You will have pain after the procedure. Ask your doctor about medication to help manage pain.
The usual length of stay is 5-14 days. It is possible that you may have to stay longer if complications arise. You may also go to a rehabilitation hospital to help you recover.
Right after the procedure, you will be in a recovery room where your blood pressure, pulse, and breathing will be monitored. Recovery may also include:
Physical therapy often starts within 24 hours after your surgery. During this time you may need devices to help you walk.
When you return home, take these steps:
Adjusting to an amputation may be difficult and can lead to depression. Consider talking to a therapist or psychologist.
Call your doctor if any of these occur:
If you think you have an emergency, call for medical help right away.
American Diabetes Association
Amputee Coalition of America
Canadian Diabetes Association
Amputation. John Hopkins Medicine website. Available at: http://www.hopkinsmedicine.org/healthlibrary/conditions/adult/physical_medicine_and_rehabilitation/amputation_85,P01141. Accessed December 3, 2013.
Amputation. Society for Vascular Surgery website. Available at:
http://www.vascularweb.org/vascularhealth/Pages/amputation.aspx. Updated February 2011. Accessed December 3, 2013.
Amputation procedure. John Hopkins Medicine website. Available at: http://www.hopkinsmedicine.org/healthlibrary/test_procedures/cardiovascular/amputation_procedure_92,P08292. Accessed December 3, 2013.
Management of critical limb ischemia. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated October 2, 2013. Accessed December 3, 2013.
Professional Guide to Diseases. 9th ed. Ambler, PA: Lippincott Williams & Wilkins; 2009.
Last reviewed December 2013 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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