One of the most common limb resection procedures is transtibial amputation, sometimes referred to as below-knee amputation. A below-knee prosthetic is used to replace the portion of the missing leg that is below the knee joint and above the ankle in a transtibial excision.
Keep reading to learn more about below-knee transtibial amputation, the prosthetic that goes along with it, and what to expect from the procedure.
What Is Below-Knee Amputation?
A transtibial amputation, also known as a below-knee amputation, is a surgical technique used to amputate a lower leg below the knee when it has suffered significant trauma or disease. Peripheral vascular disease, or a condition affecting the circulation in the lower limb, is the primary cause of transtibial amputations. Poor circulation hinders the immune system’s ability to repair and respond to harm; as a result, foot or leg ulcers may develop. These ulcers could become infected, fail to heal, or even spread to the bone, making them potentially fatal. Amputation is done to get rid of the unhealthy tissue and stop the infection from getting worse.
Finding the Right Prosthetic
Based on the patient’s physical examination results, medical history, and interview, the best prosthetic is chosen. An interface, a socket, a suspension modality, a prosthetic foot, and a connection between the socket and the foot make up a conventional prosthetic. The remaining limb’s shape is analyzed, allowing the cast to be altered to permit weight-bearing in the proper places, and a diagnostic socket is created to assess comfort and functionality. Finding an experienced prostheticist can help make this process even easier, as they will know how to help the patient get exactly what they need from their prosthetic.
Prior to Surgery
Before your surgery, your physical therapist may prescribe workouts to help you prepare for surgery and to increase your hip and knee strength and flexibility. They may also demonstrate how to use a walker or crutches to walk, as well as go over what will happen after the surgery and align your expectations, and make certain you don’t have any surprises.
After surgery, as soon as your condition is stable and your doctor gives you the all-clear for rehabilitation, physical therapy will start. A physical therapist will visit your bedside and go over your medical and surgical background. Your first two to three days of treatment could include:
- Stretching gently and performing range-of-motion activities
- Understanding the proper positioning for your surgery limb to avoid contractures (the inability to straighten the knee joint fully, which results from keeping the limb bent too much)
- Gaining knowledge of how to turn over, sit on the side of the bed, and safely transfer to a chair
Prevention of Contractures
Contracture is the tightening of soft tissues that restricts joint motion. Muscles and soft tissues stiffen as a result of immobility, leading to the disease. The knee’s flexion and inability to straighten are the most frequent contractures experienced after transtibial amputation. The hip could also potentially stiffen.
Early contracture prevention is crucial because if they are not treated after surgery, during the healing process, and once rehabilitation is complete, they may become permanent. Contractures can make it more difficult to walk and use your prosthetic, which increases the requirement for an assistance device like a walker.
Compression to Reduce Swelling
Suffering from postoperative edema is common. Your physical therapist will work with you to keep compression on your residual limb in order to safeguard it, lessen and regulate edema, and promote healing. Compression can be implemented by wrapping the limb with elastic bandages or wearing an elastic shrinker sock. These techniques also assist in shaping the limb to prepare it for prosthetic leg fitting.
Instead of using elastic bandages, a stiff dressing or plaster cast may be utilized in specific circumstances. A plaster or plastic immediate postoperative prosthetic may also be used. Each person’s situation determines the approach that is taken. Your physical therapist will help monitor the fit of these devices and train you in their use. Swelling reduction is the main objective of your care at this time.
Many patients are given prosthetic gel liners, which may be cleaned with mild soap and water every day. As soap residue might irritate the skin, it is crucial to thoroughly wash it out of the liner.
After receiving a prosthetic, the patient usually needs to undergo motion training. The patient uses the prosthesis and communicates any problems with the certified prosthetist. This could include any signs of wear to the prosthetic, any discomfort the patient may feel, and if there is persistent tissue redness even after thirty minutes of removing the prosthetic. Additional prosthetic training with a physical or occupational therapist may be necessary to keep treatment proactive, and the patient might need to wear socks to compensate for a loss in density to the volume fluctuation anytime during the day. To help prevent swelling and preserve volume overnight, it might also be suggested that a shrinker sock be worn while asleep.
The process of receiving prosthetic training can take up to a full year. When your doctor gives you the all-clear to put weight on the prosthetic, you can start. Your physical therapist will help you learn to stand, balance, and walk with the prosthetic leg. Most likely, you’ll start off with parallel bars, move on to a walker, and then, as your strength increases, you might advance to using a cane before walking independently without any support. As you resume many of the activities you engaged in prior to your amputation, you’ll also need to keep up with strengthening and flexibility exercises in order to reach your full potential. Human bodies are amazingly adaptable, but it’s best to help prepare them and train them so as to avoid additional injury from misuse.
Return to Recreational and Sports Activities
If you enjoy sports or are physically active, you might also want to speak with a recreational physical therapist who can advise you on the best-adapted recreation gear to use. The recreational physical therapist can support your return to sports like cycling, golf, hiking, jogging, and swimming depending on your own objectives and preferred leisure pursuits. Your best option for participating in these activities can also be determined by a prosthetist. Your physical therapist can assist you in locating local support groups for persons who have undergone amputation as well, which will provide you with helpful information and a community to bond with.
What You Should Know
The majority of people are unaware of the problems that may develop when they add a prosthetic to their lives. Even if some of them may cause issues, none of them will significantly impact your life as long as you take the time to learn how to deal with them. As with many things, it is best to take a proactive rather than a reactive approach.
One issue you might encounter is excessive perspiration, a condition that happens when the body is having trouble controlling its temperature. Another is the limb’s shape altering as the body gets used to the new prosthetic. The prosthetic can change shape as a result of the remaining portion of the knee rubbing and pressing on it as well, which may indicate that you require padding or perhaps a replacement.
On top of providing numerous physical and mental benefits, a high-quality prosthetic device has the ability to greatly enhance your quality of life and protect you from social isolation. If you’re ready for a below-knee prosthetic and need an experienced team to help you get exactly what you want, reach out to FitProsthetics. No matter what questions you have, we can help with them. Give us a call at (801) 912-0500 or contact us today for more information!