A below-the-knee amputation (BKA) is the surgical removal of the leg below the knee.
An amputation below the knee may be done because of:
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications, such as:
Your doctor may do the following before your procedure:
Before surgery, you will need to:
Talk to your doctor about any medications, herbs, or supplements you are taking. You may need to stop taking some medications up to 1 week before the procedure.
Do not eat or drink anything after midnight the day before your surgery, unless told otherwise by your doctor.
You may be given either:
A cut will be made in the skin below the knee. The muscles will be separated and blood vessels clamped. A special saw will be used to cut through the bone. The muscles will be sewn and shaped so that a stump is formed to cushion the bone. Nerves will be separated and placed so that they do not cause pain. Blood vessels will be tied off. The skin will be closed over the muscles, forming the stump. Drains may be inserted into the stump to drain blood for the first few days. A dressing and compression stocking will be placed over the stump.
Several hours, depending on your health and the reason for the surgery
Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
The usual length of stay is 5-14 days. It is possible that you may have to stay longer if complications arise. You may also go to a rehabilitation hospital to help you recover.
Right after the procedure, you will be in a recovery room where your blood pressure, pulse, and breathing will be monitored. Recovery may also include:
Physical therapy often starts within 24 hours after your surgery. During this time you may need devices to help you walk.
During your stay, the hospital staff will take steps to reduce your chance of infection, such as:
There are also steps you can take to reduce your chance of infection, such as:
When you return home, you will continue with physical therapy and exercise. You will be instructed on how to care for the residual limb. Medications may be prescribed to manage pain.
Adjusting to an amputation may be difficult and can lead to depression. Consider talking to a therapist or psychologist.
Contact your doctor if your recovery is not progressing as expected or you develop complications, such as:
If you think you have an emergency, call for emergency medical services right away.
American Diabetes Association
Amputee Coalition of America
Canadian Diabetes Association
Amputation. John Hopkins Medicine website. Available at: http://www.hopkinsmedicine.org/healthlibrary/conditions/adult/physical_medicine_and_rehabilitation/amputation_85,P01141. Accessed November 10, 2017.
Amputation. Society for Vascular Surgery website. Available at: https://vascular.org/patient-resources/vascular-treatments/amputation. Accessed November 10, 2017.
Amputation procedure. Johns Hopkins Medicine website. Available at: http://www.hopkinsmedicine.org/healthlibrary/test_procedures/cardiovascular/amputation_procedure_92,P08292. Accessed November 10, 2017.
Management of acute and critical limb ischemia. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T901128/Management-of-acute-and-critical-limb-ischemia. Updated September 8, 2017. Accessed November 10, 2017.
Last reviewed November 2018 by EBSCO Medical Review Board Warren A. Bodine, DO, CAQSM Last Updated: 12/20/2014