The clinical, histological and immunohistological features of a Kaposi-like acroangiodermatitis in an above-knee amputation stump are reported. There was no evidence for an underlying arteriovenous malformation and the irregular purple-blue skin lesions resulted from chronic circulatory disturbance of the distal stump caused by a poorly fitting suction-type prosthesis.

If below-knee amputation is impossible, knee disarticulation should be considered before above-knee amputation, regardless of age and etiology. Knee disarticulation which leaves the femur and patella untouched offers many advantages. The surgical technique is simple and non-traumatic since no bone or muscle tissue is to be dissected. The thigh muscles are completely preserved and thus there is no muscular imbalance. The stump permits total end bearing and its bulbous shape permits easy and firm attachment of the prosthesis. A specially designed double-wall socket and various types of knee joints are presented. Modern prostheses are superior to above-knee prostheses with regard to function, comfort and cosmesis. Results of 72 patients of all age groups are presented and discussed.

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