Total Knee Arthroplasty After Ipsilateral Below-knee Amputation: A Review of the Literature and Surgical Techniques

Patients with knee osteoarthritis in the setting of ipsilateral below-knee amputation present a challenge in terms of patient positioning, intraoperative assistance, implant alignment, postoperative rehabilitation, and prosthesis adjustment. This is a report of a patient with a history of below-knee amputation with ipsilateral knee pain due to osteoarthritis, treated with elective total knee arthroplasty. This was done using custom cutting blocks made via preoperative computed tomography scans, and a single assistant as well as a large hip bump and lateral support were used for positioning. The patient was weight-bearing as tolerated in his regular below-knee prosthesis starting from postoperative day 1, with 1 prosthetic adjustment made during the first week of rehabilitation. The patient was pain-free with full range of motion at 1-year follow-up.