Above The Knee Amputation

What you should know

• Above the knee amputation is surgery to remove your leg above your knee cap. It is also called AKA. You may need an AKA for a health problem that causes poor blood flow, such as diabetes. You may have a severe infection or a blood clot. You may have been in an accident that injured your leg beyond repair. You may also need an AKA if you have cancer, or were born with a deformed leg. Amputations are either planned or done in an emergency. Caregivers will only remove as much of you leg as is absolutely necessary. After an AKA, you may be fitted for a prosthesis (artificial leg) for your residual (remaining) limb.
  
  
• You and your caregiver will work together to decide if other treatments should be included in your treatment plan. You may need hyperbaric oxygen treatment to help heal infections. You may need surgery to provide new blood vessels to your leg if you have blood flow problems. If you have cancer, you may need surgery to remove the tumor and graft a donor bone in its place.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Risks

• During or after surgery, you may bleed more than usual. Blood may collect under your skin and form a lump called a hematoma. This may need to be drained to prevent infection. It may be difficult for your wound to heal and you may get a wound infection. You may get a blood clot in your leg or arm. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot can break loose and travel to your lungs or brain. A blood clot in your lungs can cause chest pain and trouble breathing. A blood clot in your brain can cause a stroke. These problems can be life-threatening.
  
  
• Some people continue to feel the part of their leg that has been amputated. These are called phantom feelings. These feelings are normal and may or may not be painful. If you do not have surgery, your problem could get worse. If you have cancer or a badly infected leg and do not get treatment, with time you could die. Call your caregiver if you are worried or have questions about your medicine or care.

Getting Ready

Before Surgery:

• If you know in advance that you are going to have AKA surgery, caregivers may test your good leg. These tests help you prepare for moving after surgery. You may also be given exercises to do to make your arms stronger. This will help you use crutches or a wheelchair after surgery.
  
  
• You may need blood tests before your procedure. Talk to your caregiver about these or other tests you may need. Write down the date, time and location for each test.
  
  
• If caregivers think you may need a blood transfusion during surgery, you may be able to donate your own blood before surgery. This is called autologous blood donation. This must be done no later than several days before surgery. You may also ask a family member or friend with the same blood type to donate their blood. This is called directed blood donation. Talk to your caregiver for more information on autologous or directed blood donation.
  
  
• You may be given a pill to take to help you sleep the night before surgery.
  
  
• Ask caregivers about directions for eating and drinking.

The Day of Surgery:

• Write down the correct date, time, and location of your surgery.
  
  
• Ask your caregiver before taking any medicine on the day of surgery. These medicines include insulin, diabetic pills, high blood pressure pills, or heart pills. Bring a list of your medicines or the pill bottles with you to the hospital.
  
  
• Do not wear contact lenses the day of surgery. You may wear your glasses.
  
  
• If you are staying in the hospital after surgery, bring your personal belongings with you. These include your bathrobe, toothbrush, hairbrush, and slippers. Do not wear jewelry or bring money to the hospital.
  
  
• An anesthesiologist may talk to you before your surgery. This is the caregiver who gives you medicine before and during surgery so that you do not feel or remember the surgery.

Informed consent:

A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

Treatment

What Will Happen:

• You will be asked to change into a hospital gown. You may be given medicine in your IV to help you relax or make you drowsy. You will be taken on a cart to the operating room. You will get general anesthesia to keep you completely asleep during surgery.
  
  
• During surgery, caregivers will try to remove the diseased tissue so that your wound will heal well. Caregivers will also try to form your residual (remaining) limb so that a prosthesis will fit well on it. Caregivers will only remove as much of your leg as is absolutely necessary. An incision (cut) will be made in your leg above your knee. The part of your leg below that will be removed, and your thigh bone will be made smooth. A flap, made of muscle, tissue, and skin will be made to cover the end of your bone. If your leg was infected before surgery, caregivers may not put sutures (thread) or staples in to close it right away. The incision may be left open for several days after surgery. If no infection was present, the incision will be closed with stitches. The surgery may last one to two hours.

After surgery:

You are taken to a room where your heart and breathing will be monitored. Do not get out of bed until your caregiver says it is okay. A bandage may cover wounds to help prevent infection. You may be able to go home after some time passes. An adult will need to drive you home and should stay with you for 24 hours. If you cannot go home, you will be taken to a hospital room.

Waiting Room:

This is a room where your family can wait until you are through surgery. Your doctor or nurse will find them there to let them know how the surgery went. If your family leaves the hospital, ask them to leave a phone number where they can be reached.

Contact a caregiver if

• You cannot make it to your surgery appointment on time.
  
  
• You have questions or concerns about your surgery.
  
  
• You have a fever.
  
  
• The problems for which you are having the surgery get worse.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Above The Knee Amputation (Precare)