The Gritti–Stokes amputation in ischaemia: A review of 134 cases

Abstract

The results of 134 Gritti-Stokes amputations for ischaemia are presented. The mortality rate was 11% and healing occurred in 88%, reaffirming the good results already reported for this operation. The long term results are reviewed in an attempt to decide whether the most frequently cited criticisms of this procedure are justified. Stump pain and mobility of the patella were not major problems. The difficulties in fitting a suitable prosthesis are discussed and attention is drawn to the advantages of a new prosthesis that has been developed for this amputation.

Through-knee amputation in patients with peripheral arterial disease: A review of 50 cases

“…which showed favorable outcomes of TKAmp in patients with PAD has prompted a resurrection of the procedure, particularly in Great Britain. 2,11,[21][22][23][24] However, the outcome of TKAmp is rarely reported in the United States except for an occasional report in the orthopedic literature.…”

“…4,5,11,[20][21][22][23][24] Most of the other series, however, included patients who did not have peripheral vascular disease but had wounds related to infectious com- plications of diabetes mellitus. All the patients in our series had vascular disease with leg wounds or ischemia that precluded even a short BKA.…”

“…Indeed, we noted that in series reporting outcome of TKAmp in patients with PAD that the prevalence of wound complications and reamputation tends to be lower in studies that shaved the femoral condyles. 4,5,23 We believe the functional advantages of TKAmp over AKA and the very acceptable wound healing rate achieved with the modified Mazet technique justify the procedure in patients who are good candidates for rehabilitation. A similar rationale is used to justify performing BKA in patients who are candidates for rehabilitation despite a 20% incidence of wound complications reported for BKA.…”

A review of through-knee amputation

“…The femur is cut transversally at either 0°, [26][27][28][29] 10-15°9 , 19 or 45°to the horizontal. [30][31][32][33] The posterior surface of the patella is shaved down to the cancellous bone and attached, with tension, to the distal cut end of the femur for weight bearing. The patellar tendon is attached to the posterior flap to prevent movement of the patella and potential damage to the soft tissue.…”

“…The patellar tendon is attached to the posterior flap to prevent movement of the patella and potential damage to the soft tissue. 9,[26][27][28][29][30][31][32][33] A longer anterior flap for a posterior scar is performed according to the majority of descriptions. 9,26-28,30-33 However, Albino et al proposed a gastrocnemius flap, perhaps as they report division of the femur more distally than the other descriptions.…”