Disarticulation at knee
CPT4 code
Name of the Procedure:
Disarticulation at Knee
Common name(s): Knee disarticulation
Technical/Medical term: Trans-femoral amputation at the knee
Summary
Knee disarticulation is a surgical procedure where the leg is amputated through the knee joint. The femur (thigh bone) remains intact while the tibia and fibula (lower leg bones) are removed.
Purpose
The primary purpose of knee disarticulation is to address severe trauma, infection, or disease affecting the lower leg that cannot be treated through other means. The goal is to remove the diseased or damaged tissue to improve the patient's quality of life and prevent further complications.
Indications
- Severe trauma or injury to the lower leg
- Irreparable damage due to diabetes or vascular disease
- Uncontrollable infections or chronic osteomyelitis
- Tumors or cancerous growths in the lower leg
- Severe deformity or non-functional limb
Preparation
- Fasting for 6-8 hours before the procedure
- Medication adjustments as advised by the doctor
- Pre-surgical assessments including blood tests, X-rays, and MRIs
- Psychological evaluation and counseling
Procedure Description
The procedure begins with the administration of general or regional anesthesia. The surgeon makes an incision around the knee joint, detaching muscles and ligaments while preserving as much healthy tissue as possible. The femur is left intact while the tibia and fibula are removed. Blood vessels and nerves are carefully managed to minimize trauma. The wound is then closed, often with sutures, and a sterile dressing is applied.
Tools and Equipment:
- Scalpel
- Surgical clamps
- Bone saw
- Sutures
- Sterile dressings
Anesthesia: General anesthesia or regional/spinal anesthesia
Duration
The procedure typically takes 1.5 to 3 hours.
Setting
Knee disarticulation is performed in a hospital operating room.
Personnel
- Orthopedic surgeon or vascular surgeon
- Anesthesiologist
- Surgical nurses
- Surgical technicians
Risks and Complications
- Infection
- Blood clots
- Phantom limb pain
- Poor wound healing
- Adverse reaction to anesthesia
- Loss of mobility
Benefits
- Relief from pain and infection
- Improved quality of life
- Prevention of further complications
- Potential for prosthetic fitting and improved mobility
Recovery
- Hospital stay of 5-7 days post-surgery
- Pain management with medications
- Physical therapy to strengthen remaining limb and adapt to mobility aids
- Stump care instructions to prevent infection
- Follow-up appointments for wound care and prosthetic fitting
Alternatives
- Below-knee amputation (more functional but not always possible)
- Limb salvage techniques (if applicable)
- Non-surgical management with medical treatment and physical therapy
Patient Experience
Patients may experience discomfort and emotional challenges during the initial recovery period. Pain management, psychological support, and physical rehabilitation are crucial for easing the transition. Adjustments to day-to-day life and possible fitting for a prosthetic limb will follow.