Following a transfemoral (above-the-knee) amputation, it’s natural to have many questions: What’s next? How will I move around? What will my future look like? Fortunately, there are numerous people, organizations, and resources that can support you and your family throughout the recovery process. This is just one of the many resources offered by the Amputee Coalition to assist you on your journey.
Almost 2 million people in the United States are living with limb loss, with approximately 1.3 million, or 65%, having an amputation involving a lower limb. More than 580,000 individuals in the U.S. have above-knee amputations. Each year, an average of 132,723 lower-limb amputations are performed in the country, with just over 16% of those being above-knee procedures.
Most lower-limb amputations are caused by complications from vascular disease and diabetes. Other leading causes include infection and trauma. Cancer accounts for just 1% of lower-limb amputations.
A few weeks following surgery, your care will shift from suture and staple removal to focusing on wound care and pain management.
Over the next three months, your surgeon will hand off your care to your primary care physician or a physical medicine and rehabilitation (PM&R) specialist.
The rehabilitation process and timeline after an above-knee amputation are highly individualized. During the first 12 months, you will work with many different healthcare professionals who will help to guide your physical and emotional recovery. Some of these professionals will be a part of your life for a short time, and others will become lifelong care providers.
Your rehabilitation care providers should function as a team. They should communicate with you and each other to help you to recover and regain as much function as possible.
Taking an active role in your recovery is no small task. It will require acceptance, focus, dedication, persistence and patience.
Members of your rehabilitation team will provide you with guidance, recommendations and tools as you recover. But you are the center of your rehabilitation team. You must decide what will work best for you and communicate your decisions openly and honestly with your healthcare providers.
Tell your healthcare team about your goals.
If you played golf before your amputation and would like to resume that activity – or if you would like to try a different activity – tell your healthcare providers.
You should know and understand your K level and how it will impact the type of prosthetic device you will be working with. If there are activities you are interested in returning to (golf, running, working, etc.), be sure your physician and your prosthetist are aware of your goals.
Your primary care physician or physiatrist (a specialist in physical medicine and rehabilitation) serves as the lead doctor on your rehabilitation team, overseeing your care plan. They focus on managing pain and medications and act as your primary point of referral for emotional healthcare, physical therapy, prosthetic treatments, social services, and return-to-work support.
Whether or not you choose to use a prosthesis, it’s important to begin working with a physical therapist as soon as possible after your amputation. Regular weekly sessions over several months will be essential to help you build the skills needed for daily mobility.
Physical therapists play a crucial role in preparing you for daily mobility.
They can assist you with:
Once you’ve selected the most suitable assistive device, your physical therapist will guide you on how to use it safely and effectively.
Once you choose the assistive device that best suits your needs, your physical therapist will guide you on its safe and effective use.
A prosthetist is a certified healthcare professional specializing in designing, fabricating, and fitting comfortable and functional prosthetic devices. Establishing a good working relationship with your prosthetist is essential, as it will be a long-term partnership.
During the first month after surgery, you will have several appointments with your prosthetist. They will fit you with an elastic sock, known as a shrinker, to help shape your residual limb for the initial prosthetic fitting.
If you choose to use a prosthetic device, your prosthetist will guide you on how to put it on (don), remove it (doff), make necessary adjustments, and care for it. Once a comfortable fit is achieved, follow-up visits will be regular but less frequent.
Unlike many other forms of medical care, prosthetic services are not billed on a per-visit basis. Instead, the cost of the prosthetic device typically includes consultation, evaluation, authorization, fitting, delivery, and follow-up care. Be sure to ask your prosthetist if there are any time limits on follow-up adjustments.
After an amputation, regular visits to your prosthetist will be necessary to fine-tune the fit of your prosthesis. As swelling in your residual limb decreases, these visits may become less frequent. However, it’s important to maintain a routine check-up schedule to ensure your prosthesis remains comfortable and functions properly.
Maintain open communication and be honest and transparent with your case manager about your needs. They can help connect you with available resources and services in your community.
