(Amputation, Below-the-Knee; BKA)
by Cynthia M. Johnson, MA
A below-the-knee amputation (BKA) is the surgical removal of the leg below the knee.
Reasons for Procedure
An amputation may be done for:
Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:
Things that may raise the risk of problems are:
What to Expect
Prior to Procedure
The surgical team may meet with you to talk about:
The doctor may give:
Description of Procedure
An incision will be made in the skin below the knee. The muscles will be divided and the blood vessels clamped. A special saw is used to cut through the bone. The muscles are then sewn and shaped. It will form a stump that will cushion the bone. Nerves are divided and placed so they do not cause pain. The skin is closed over the muscles. Drains may be inserted into the stump. It will allow blood and fluids to drain from the area in the first few days after surgery. A dressing and compression stocking will be placed over the stump.
How Long Will It Take?
It may take many hours. It depends on the reason for the surgery.
How Much Will It Hurt?
Pain and swelling are common in the first month. Medicine and home care can manage pain.
Average Hospital Stay
The usual length of stay is 5 to 14 days. If you have any problems, you may need to stay longer.
At the Hospital
Right after the procedure, the staff may:
Physical therapy will be started soon after surgery. The care team will teach you how to use any assistive devices.
During your stay, staff will take steps to lower your chance of infection, such as:
You can also lower your chance of infection by:
It will take 1 to 2 months for the remaining limb to heal. Physical activity will be limited during recovery. You may need to ask for help with daily activities and delay return to work. You will need to learn new ways to do daily tasks. This may take up to a year.
Call Your Doctor
Call the doctor if you are not getting better or you have:
If you think you have an emergency, call for medical help right away.
American Diabetes Association
Ortho Info—American Academy of Orthopaedic Surgeons
Canadian Diabetes Association
The Canadian Orthopaedic Association
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Accessed September 28, 2020.
Amputation. Society for Vascular Surgery website. Available at: https://vascular.org/patient-resources/vascular-treatments/amputation. Accessed September 28, 2020.
Management of acute and critical limb ischemia. EBSCO DynaMed website. Available at:
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Accessed November 10, 2017.
Rooke TW, Hirsch AT, et al. 2011 American College of Cardiology Foundation/American Heart Association Focused Update of the Guideline for the Management of patients with peripheral artery disease (Updating the 2005 Guideline): a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2011 Nov 1;124(18):2020-2045.
Last reviewed September 2020 by EBSCO Medical Review Board Warren A. Bodine, DO, CAQSM
Last Updated: 6/8/2021
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