Most of these amputations are either transtibial or transfemoral, with knee-disarticulation amputations being relatively uncommon and representing less than 2 percent of all amputations .
In 1940, Rogers reopened the discussion regarding the role of knee-disarticulation amputation by extolling its virtues in terms of end weight bearing and the uninterrupted femoral epiphysis .
Utilizing the four-bar linkage knee, patients with knee-disarticulation amputations have better physiological costs of walking than do patients with transfemoral amputation [25-27].
Despite recent improvements in surgical technique and advances in prosthetic technology, knee-disarticulation amputations are currently infrequently utilized and are performed predominantly on elderly patients, pediatric patients, spinal cord injury patients, and nonambulatory patients.
Our current study systematically compared persons with knee-disarticulation amputation with persons with transtibial and transfemoral amputations in terms of pain, pain-related interference with physical function, and prosthesis use.
Fourteen participants reported a single knee-disarticulation amputation and no other amputations.
Continuous outcome measures were analyzed by a one-way analysis of variance (ANOVA) procedure with amputation site (transfemoral amputation, knee-disarticulation amputation, transtibial amputation) serving as the between-subjects variable.
Of the 5 subjects who did not wear prostheses, 2 were in the transfemoral amputation group and 3 were in the knee-disarticulation amputation group.
Estimating effect size using Cohen's d, we found that the transtibial amputation group wore their prostheses more hours per day than the knee-disarticulation amputation group (d = -1.
Of the 42 total participants group, 6 in the knee-disarticulation amputation group, and 4 in the transtibial amputation group denied phantom limb pain and therefore did not answer further study questions regarding phantom limb pain and phantom limb pain-related interference.