Murakami Tsurayuki, Murray Kevin
Department of Biomedical Engineering, National Centre for Prosthetics and Orthotics, University of Strathclyde, Glasgow, UK.
Department of Biomedical Engineering, National Centre for Prosthetics and Orthotics, University of Strathclyde, Glasgow, UK
Prosthet Orthot Int. 2016 Aug;40(4):423-35. doi: 10.1177/0309364615574163. Epub 2015 Mar 27.
Dysvascularity is the main cause of lower limb amputations in Scotland, and there is an insignificant proportion (1.7%) of knee disarticulations, despite the benefits of amputation.
The outcomes of knee disarticulation and its associated surgical techniques will be evaluated based on healing, reamputations, functional outcomes, prosthetic ambulation and gait biomechanics to determine whether a greater rate of knee disarticulations can be justified among dysvascular patients.
Systematic review.
Key electronic databases were searched for the relevant literature based on a pre-specified eligibility criterion.
The 17 articles included in this review were appraised for their quality, and key findings are extracted.
Healing rates are favourable, but there is a need for appropriate amputation level selection to prevent reamputations. Knee disarticulation patients have better maintenance of independent living status than transfemoral patients, but overall prosthetic ambulation rates are inconsistent. In terms of gait biomechanics of knee disarticulation, there are some positive indications, but the evidence is insubstantial. A stronger body of evidence is required in this subject field, and recommendations are made for future research - Scottish Intercollegiate Guidelines Network Grade of Recommendation: C.
This review aims to inform the multidisciplinary teams involved in the rehabilitation of dysvascular amputees about evidence-based outcomes following knee disarticulation. This knowledge will be beneficial when formulating treatment pathways for this vulnerable population group.
血管性疾病是苏格兰下肢截肢的主要原因，尽管截肢有诸多益处，但膝关节离断术的比例却微不足道（1.7%）。
基于愈合情况、再次截肢情况、功能结果、假肢行走及步态生物力学来评估膝关节离断术的结果及其相关手术技术，以确定在血管性疾病患者中是否有理由提高膝关节离断术的比例。
系统评价。
根据预先设定的纳入标准，在主要电子数据库中检索相关文献。
对本评价纳入的17篇文章进行质量评估，并提取关键发现。
愈合率良好，但需要选择合适的截肢平面以防止再次截肢。膝关节离断术患者比经股骨截肢患者能更好地维持独立生活状态，但总体假肢行走率并不一致。就膝关节离断术的步态生物力学而言，有一些积极迹象，但证据并不充分。该主题领域需要更有力的证据，并对未来研究提出了建议——苏格兰校际指南网络推荐等级：C。
本评价旨在让参与血管性疾病截肢患者康复的多学科团队了解膝关节离断术后基于证据的结果。这些知识在为这一弱势群体制定治疗方案时将有所帮助。
