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  • Title: Ambulation levels of bilateral lower-extremity amputees. Analysis of one hundred and three cases.
    Author: Volpicelli LJ, Chambers RB, Wagner FW.
    Journal: J Bone Joint Surg Am; 1983 Jun; 65(5):599-605. PubMed ID: 6853564.
    Abstract:
    One hundred and three bilateral lower-extremity amputees were evaluated to determine their eventual ambulation level. Of thirty-eight bilateral above-the-knee amputees, two with traumatic amputation were prosthetically rehabilitated, while none of the thirty-five with dysvascular amputation were so rehabilitated. Twenty-two of the dysvascular above-the-knee amputees were wheelchair ambulators and thirteen were bedridden. Prosthetic rehabilitation has been successful for traumatic bilateral above-the-knee amputees but has never been successful for our dysvascular bilateral above-the-knee amputees. The goal for dysvascular bilateral above-the-knee amputees is wheelchair ambulation. Of twenty-one patients with combinations of above-the-knee and below-the-knee amputations, five were prosthetically rehabilitated, including four dysvascular amputees; ten were wheelchair ambulators; and six were bedridden. Of forty-four patients with bilateral below-the-knee amputation, thirty-five were prosthetically rehabilitated and the remaining nine were wheelchair ambulators. Since the success rate for prosthetic rehabilitation is higher for amputees with combination above-the-knee and below-the-knee amputation than for those with bilateral above-the-knee amputation, and again increases for those with bilateral below-the-knee amputation, the significance of preserving the knee joint, even a single knee, cannot be overemphasized.
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