- V49.76 Above-knee amputation status
- Z89.619 Acquired absence of unspecified leg above knee
- 4J: Impaired motor function, muscle performance, range
of motion, gait, locomotion, and balance associated with amputation
- Result of ultimate loss of tissue perfusion from the surrounding
circulation at any level proximal to the femoral condyles
- A transfemoral amputation is an amputation of the lower limb
between the knee and the hip.
- Surgeon makes diagnosis after surgery.
- A transfemoral amputation is made between the femur at the
level of the greater trochanter and proximal to the level of the
- Efforts are made to preserve the attachment of the adductor
magnus at the medial distal third of the femur to maintain the normal
biomechanical alignment of the femur.
- An amputation at the level proximal to the greater trochanter
of the femur is called a hip disarticulation.
- The amputation of the entire lower extremity (LE) and half
of the ipsilateral pelvis is called a hemipelvectomy.
- Loss of a limb above the knee results in widespread impairments
in body structure and function as well as significant activity limitations
and participation restrictions that will ultimately affect the individual’s
participation in family and home life as well as reintegration into
- Emotional support and education must infiltrate postoperative
rehabilitation beginning on postoperative day one to assist the
individual with repossessing life roles.
- The total recovery period is consistently 12 to 18 months
and includes activity recovery, reintegration, prosthetic training,
and prosthetic management.
- The acute hospital stay ranges from 5 to 14 days, and the
post-acute hospital stay could range from 2 to 8 weeks.
- This period includes surgery recovery, wound
healing, early rehabilitation, and determination of prosthetic readiness.
- The immediate recovery stage begins with the healing of the
wound and could extend up to 6 months.
- This stage ends with stabilization of limb
volume after accommodating to prosthetic use with ambulation.
- The last stage of recovery is widely variable. During this
time, limb volumes continue to stabilize but are no longer rapidly
- Prosthetic adjustments can be made as the
limb continues to stabilize.
- When the prosthesis is worn full time for a period of at least
6 months and the limb volume has stabilized
to a point that socket fit remains relatively consistent for at
least 2 to 3 weeks, a definitive prosthesis may be indicated.
- Higher-level functional training and social reintegration
mark the end of this stage.
- Promotion of independence can start as early as postoperative
day one with quadriceps and gluteus medius and maximus strengthening
of the contralateral limb.
- Exercises that promote muscle control of the residual limb
depend on the patient’s pain tolerance, the surgical procedure,
and the healing response. Clear communication among the care team
- Trunk stability will assist with mobility activities ...
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