Although some view choosing below the knee amputation as a failure, most patients are relieved and find that life after amputation has significantly improved. The painful and dysfunctional leg is replaced with an advanced prosthesis that permits return to almost all sports and activities.
Is the possibility of an amputation in your future?
If so, let Dr. Silverman help.
For more information about below the knee amputation and limb reconstruction, keep reading.
What Happens Before Amputation Below The Knee?
The surgery center will give you individualized advice on how to prepare in the days leading up to surgery. On the day of surgery, the anesthesiologist will administer regional anesthesia known as a popliteal nerve block. You will be placed on your stomach and injected with Novacaine-like medication around the nerve in your leg. This gives complete pain relief that lasts for 12 to 36 hours. Patients report extraordinary satisfaction with this type of anesthesia. Some patients chose an epidural block which numbs both of their legs below the waist. You can discuss this with your anesthesiologist prior to surgery. You will be given antibiotics just before surgery to help prevent infection.
What Happens During Amputation Below The Knee?
During surgery you will be given general anesthesia and be in a sleep-like state. A tourniquet will be placed around your thigh. Incisions will be made around the leg in order to fashion appropriately sized skin flaps. Then the leg will be removed. The Ertl procedure includes creating a cap on the end of the amputated bone.
What Happens After Amputation Below The Knee?
You will be permitted to leave the recovery room once your anesthesiologist is satisfied that you have recovered. Most patients end up staying in the hospital for 1-3 days before being discharged. You will be given crutches or a walker and will start physical therapy the day after surgery. Take your narcotic pain control medications before falling asleep or as you feel the “numbing” effect wearing off. Remember post operative pain is much easier to control with prevention.
Below Knee Amputation General Recovery Timeline
This timeline is a general guideline. Your post-operative course may vary.
| Elevation | 23 hours / day for 3 days; then keep elevated as needed. Swelling may last over 4 months. |
| Motion | Bend and fully straighten your knee and hip several times per day. Keep Flow-Tec in place during the night and while walking. Knee contractures occur if the leg is left bent during the recovery period. |
| Walking | You may begin using a prosthesis when the swelling resolves adequately between 4-6 weeks following surgery. |
| Bathing | You may shower 3 days after surgery. Do not bathe until the staples have been removed. |
| Pain Control | Expect to use strong narcotics for the first 3-5 days. Wean off as soon as you are comfortable using Tylenol or Ultram (Rx only). NSAIDS such as Motrin and Naprosyn are good pain relievers as well. Medications like Neurontin, Lyrica, and Elavil are used to relieve symptoms of nerve or phantom pains. |
| Work | Return depends on specific demands. It is safe to return to sedentary work at 14 days post-op. Return to heavy labor will take at least 4 months. |
| Driving | Patients with left leg surgery may drive an automatic transmission. Patients with right leg surgery have special considerations for driving. |
Routine Clinic Visits
| 2 weeks | Staple removal and begin working with Prosthetist. |
| 6 weeks | Fitting with a temporary prosthesis. |
| 3+ and 6 months | Please see me as needed. Call or email my office to inform us of your progress. |
Patients who have selected this procedure are generally very satisfied with the results. The decision to undergo an amputation should never be taken lightly; however, most patients who have chosen this course are relieved of both physical pain and emotional stress.
For more helpful tips, check out these rehab exercise videos that will help you recover, or reach out to Dr. Silverman for more information!