A transfemoral amputation is a lower extremity amputation done by cutting through the femur, the large bone in the upper leg. It is also known as an above-the-knee amputation, and the precise height of the amputation varies, depending on the case. When preparing for a transfemoral amputation, the doctor takes some time to plan ahead, selecting the optimal position for the patient's future ability to balance and use a prosthesis without compromising the quality of medical care. This amputation is challenging to adapt to, as the loss of the knee joint makes it harder to learn to walk again, and the experience can be emotionally traumatic.
Amputation is recommended when other approaches to treatment for a condition involving the leg have not been successful. Some potential reasons to need an amputation include severe trauma, infection, and vascular disease. If a transfemoral amputation is indicated, a meeting will usually be held with the patient first, if possible, to talk about the procedure and provide the patient with some information on recovery. In the operating room, the amputation is carefully mapped out, with the surgeon drawing and cutting skin flaps to cover the stump before carefully sectioning through the structures in the leg. The surgical site is closed and the patient is moved to recovery.
Pain levels are often very high after a transfemoral amputation. Patients can also experience a phenomenon known as phantom limb pain,where nerves send signals from the limb as though it is still there. Recovery involves regularly changing bandages and inspecting the site, with the patient initially using wheelchairs and crutches for mobility. When the site is healed, fitting for a prosthesis can begin, and the patient can be taught how to walk again.
Studies on people with transfemoral amputations have shown that they invest more energy in walking than people with below-the-knee amputations and individuals with both legs intact. During recovery, this can lead to rapid onset of fatigue as the patient learns to walk and adjusts habits to adapt to the limb loss. In the case of double amputees, the recovery period can be long as the patient develops adaptations and new life skills.
Historically, amputation has been considered to be a failure of treatment by physicians. Amputees and some members of the medical community have pushed back on this attitude, suggesting that it can be deleterious to mental health for patients, as well as doctors. These people argue that transfemoral amputation is not a failure of treatment, but a very legitimate and appropriate treatment option for some kinds of medical conditions. Removal of a diseased limb can help patients enjoy a long, healthy life free of pain and complications.