The Journal of Bone and Joint Surgery 82:1089 (2000)
© 2000 The Journal of Bone and Joint Surgery, Inc.
Correlations with Patients' Perspectives of the Result of Lower-Extremity Amputation*
Susanna L. Matsen, B.S. ,
Dee Malchow, R.N. and
Frederick A. Matsen, III, M.D.
Investigation performed at the Department of Orthopaedics,
University of Washington, and Harborview Medical Center, Seattle,
Washington
*No benefits in any form have been received or will be received
from a commercial party related directly or indirectly to the subject
of this article. No funds were received in support of this study.
Department of Orthopaedics, University of Washington, Box 356500,
1959 N.E. Pacific, Seattle, Washington 98195-6500.
Department of Orthopaedics, Harborview Medical Center, Box 359798,
325 Ninth Avenue, Seattle, Washington 98104.
Background: Patients' perceptions of the
result of lower-extremity amputation vary widely, yet the factors
associated with this variability are not well understood. Our objective
was to identify important correlations with the perceived result
that may help to indicate the factors that deserve particular emphasis
in the management of patients who have had an amputation.
Methods: In this retrospective study, 148 patients
who had had a major lower-extremity amputation completed a standardized
questionnaire designed to assess the demographic characteristics,
comorbidities, amputation characteristics, prosthetic function, and
social function at a mean of seven years after surgery. We correlated
each of these variables with four result metrics: general satisfaction,
quality of life, freedom from frustration, and walking distance.
Results: The four result metrics were significantly
and strongly correlated with (1) the comfort of the residual limb;
(2) the condition of the contralateral limb; (3) the comfort, function,
and appearance of the prosthesis; (4) social factors; and (5) the
ability to exercise recreationally (p < 0.0001). Interestingly,
the level and laterality of the amputation were not significantly
correlated with the patients' perceived result.
Conclusions: The perceived result of amputation
is not associated with the amount of the limb that was amputated
but rather with factors that may be optimized by surgical, prosthetic,
and social management.

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