Volpicelli L J, Chambers R B, Wagner F W
J Bone Joint Surg Am. 1983 Jun;65(5):599-605.
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.
对103例双侧下肢截肢患者进行了评估，以确定他们最终的步行能力。在38例双侧膝上截肢患者中，2例创伤性截肢患者接受了假肢康复治疗，而35例血管性截肢患者均未接受此类康复治疗。22例血管性膝上截肢患者使用轮椅行走，13例卧床不起。假肢康复治疗对创伤性双侧膝上截肢患者取得了成功，但对我们的血管性双侧膝上截肢患者从未成功过。血管性双侧膝上截肢患者的目标是使用轮椅行走。在21例膝上和膝下截肢组合的患者中，5例接受了假肢康复治疗，其中包括4例血管性截肢患者；10例使用轮椅行走；6例卧床不起。在44例双侧膝下截肢患者中，35例接受了假肢康复治疗，其余9例使用轮椅行走。由于膝上和膝下截肢组合的截肢患者的假肢康复成功率高于双侧膝上截肢患者，而双侧膝下截肢患者的成功率再次提高，因此，保留膝关节，即使是单个膝关节的重要性无论如何强调都不为过。
