Amputation, thigh, through femur, any level
CPT4 code
Name of the Procedure:
Amputation, thigh, through femur, any level
Common Name(s): Above-Knee Amputation (AKA), Transfemoral Amputation
Summary
Amputation, thigh, through femur, is a surgical procedure to remove a portion of the leg above the knee. It is commonly performed when other treatments cannot resolve limb-threatening conditions.
Purpose
The procedure addresses severe injuries, infections, tumors, or lack of blood supply to the lower limb. The goal is to remove diseased tissue, alleviate pain, and potentially enable prosthetic use to improve mobility and quality of life.
Indications
- Severe trauma to the thigh or leg
- Chronic, non-healing infections
- Peripheral artery disease causing limb ischemia
- Malignant tumors in the bone or soft tissue
- Severe burns or frostbite not amenable to other treatments Criteria include non-viable lower limb despite conservative treatments and sufficient general health to undergo surgery.
Preparation
- Fasting for at least 8 hours before surgery
- Medication adjustments as directed by the healthcare provider
- Preoperative assessment which may include blood tests, ECG, imaging studies
- Psychological evaluation and counseling may also be provided
Procedure Description
- Administer anesthesia (general or spinal).
- The surgeon makes an incision in the thigh.
- Muscles and tissues are carefully separated to expose the femur.
- The femur is cut at the level determined during preoperative planning.
- Blood vessels are sealed, and nerves are managed to reduce pain.
- Muscle and skin flaps are shaped to cover the bone end.
- The incision is closed with sutures or staples and dressed.
The procedure uses surgical instruments, cautery devices, and sometimes bone saws.
Duration
Typically takes 1 to 2 hours.
Setting
Performed in a hospital operating room.
Personnel
- Surgeon
- Surgical assistants
- Anesthesiologist
- Nurses
- Possibly a vascular surgeon for cases involving blood vessels
Risks and Complications
- Infection
- Bleeding
- Blood clots
- Phantom limb pain
- Poor wound healing
- Joint contractures Complications are managed with medications, physical therapy, and sometimes additional surgery.
Benefits
- Relief from pain or infection
- Improved quality of life
- Potential use of prosthetics Benefits are often realized within weeks to months, depending on recovery and rehabilitation progress.
Recovery
- Hospital stay lasts a few days to a week
- Pain management with medications
- Wound care and monitoring for infection
- Physical therapy starts soon after to maintain strength and mobility
- Prosthetic fitting and rehabilitation planning
- Follow-up appointments to monitor healing Recovery time varies but generally spans several weeks to months.
Alternatives
- Limb-sparing surgery
- Revascularization procedures
- Intensive wound care
- Hyperbaric oxygen therapy
- The choice depends on the severity and nature of the condition. Alternatives may have their own risks and lower success rates compared to amputation.
Patient Experience
Patients may experience:
- Anesthesia effects during and after the procedure
- Post-operative pain managed with medications
- Emotional and psychological impact
- Physical adjustments and gradual rehabilitation Healthcare teams provide comprehensive support to manage pain and ensure comfort.