0
Letters to the Editor   |    
Below-the-Knee Compared with Above-the-Knee Amputation
Jacquelin Perry, MD, ScD1
1 Pathokinesiology ServiceRancho Los AmigosNational Rehabilitation Center7601 East Imperial HighwayDowney, CA 90242pklab@larei.org
View Disclosures and Other Information
The author did not receive grants or outside funding in support of her research or preparation of this work. She did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the author is affiliated or associated.

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2005 May 01;87(5):1162-a-1163
5 Recommendations (Recommend) | 3 Comments | Saved by 3 Users Save Case

Extract

To The Editor: Recently my attention was directed to the article "Functional Outcomes Following Trauma-Related Lower-Extremity Amputation" (2004;86:1636-45, 2503), by MacKenzie et al. This multicenter study included a monumental mass of data and imparts valuable information about the psychological impact of traumatic amputations, but the authors also offered two major, unsupported conclusions.First, the outcome of above-the-knee amputations was presented as superior to those of below-the-knee amputations, but this conclusion is contradicted by other data. The SIP (Sickness Impact Profile) scores showed that the outcomes of the above-the-knee amputations equaled or exceeded those of the below-the-knee amputations. This interpretation, however, is refuted by a statement in the text that "none of the differences... was significant at the p < 0.05 level." Another contradiction is found in the statement: "the walking speed of the patients with a below-the-knee amputation was significantly faster than that of the patients with an above-the-knee amputation." Sixty-two percent of the patients with a below-the-knee amputation had a walking speed equal to or faster than 4 ft/sec compared with 43.5% of those with an above-the-knee amputation, and 23.1% of those with an above-the-knee amputation were unable to walk independently over uneven ground compared with 11.3% of those with a below-the-knee amputation.
Figures in this Article

    First Page Preview

    View Large
    />
    First page PDF preview
    Sign In to Your Personal ProfileSign In To Access Full Content
    Not a Subscriber?
    Get online access for 30 days for $35
    New to JBJS?
    Sign up for a full subscription to both the print and online editions
    Register for a FREE limited account to get full access to all CME activities, to comment on public articles, or to sign up for alerts.
    Register for a FREE limited account to get full access to all CME activities
    Have a subscription to the print edition?
    Current subscribers to The Journal of Bone & Joint Surgery in either the print or quarterly DVD formats receive free online access to JBJS.org.
    Forgot your password?
    Enter your username and email address. We'll send you a reminder to the email address on record.

     
    Forgot your username or need assistance? Please contact customer service at subs@jbjs.org. If your access is provided
    by your institution, please contact you librarian or administrator for username and password information. Institutional
    administrators, to reset your institution's master username or password, please contact subs@jbjs.org

    References

    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
    CME Activities Associated with This Article
    Submit a Comment
    Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
    Comments are moderated and will appear on the site at the discretion of JBJS editorial staff.

    * = Required Field
    (if multiple authors, separate names by comma)
    Example: John Doe





    Related Content
    The Journal of Bone & Joint Surgery
    JBJS Case Connector
    Topic Collections
    Related Audio and Videos
    Clinical Trials
    Readers of This Also Read...
    JBJS Jobs
    01/22/2014
    Pennsylvania - Penn State Milton S. Hershey Medical Center
    04/16/2014
    Ohio - OhioHealth Research and Innovation Institute (OHRI)
    04/16/2014
    Georgia - Choice Care Occupational Medicine & Orthopaedics