949 - Rates of Prosthetic Prescription After Lower Limb Amputation in Patients with Dysvascular Disease

Thursday, February 19, 2026

5:00 PM - 6:30 PM AST

Co-Author(s)

JD

Jennifer Dens Higano, MD, MPP

Senior Associate Consultant, Physical Medicine and Rehabilitation
Mayo Clinic
Rochester, Minnesota, United States

Presenting Author(s)

LB

Lori Bjork, MD

Resident, Physical Medicine and Rehabilitation
Mayo Clinic
Rochester, Minnesota, United States

Co-Author(s)

VW

Vanessa Wanjeri, MD

Physician
Physical Medicine and Rehabilitation, Southern Ohio Medical Center
Portsmouth, Ohio, United States
KG

Kerly Guevara Maldonado, MD

Research Fellow
Mayo Clinic
Rochester, Minnesota, United States
CM

Charlotte McGuckin, BA

Medical Student
Mayo Clinic Alix School of Medicine
Rochester, Minnesota, United States
TB

Toure Barksdale, MD

Consultant and Assistant Professor, Physical Medicine and Rehabilitation
Mayo Clinic
Rochester, Minnesota, United States
CS

Clay Smither, MD

Chair and Consultant, Physical Medicine and Rehabilitation
Mayo Clinic
Rochester, Minnesota, United States

Submitter(s)

LB

Lori Bjork, MD

Mayo Clinic
Rochester, Minnesota, United States

Objectives: Most lower limb amputations are related to dysvascular disease. The prevalence of limb loss is expected to rise as comorbidities contributing to dysvascular disease increase. Patients with limb loss have variable rates of prosthetic use depending on level of amputation, comorbidities, and prior level of function. This study characterizes prosthetic use among patients after initial dysvascular lower limb amputation.

Design: Retrospective chart review extracted data from a single center on adult patients ≥ 18 years old with transmetatarsal, transtibial, knee disarticulation, or transfemoral amputation between June 1, 2018 and June 1, 2022. Chart review identified patients with first major lower limb amputation due to dysvascular etiology resulting in a cohort of n=390 patients. Patients with prior major dysvascular amputation or amputations due to trauma, malignancy, arteriovenous (AV) malformation, or failed joint replacement were excluded.

Results: Of n=390 patients, transtibial amputation was the most common procedure (72.1%, n=281), followed by transmetatarsal amputation (17.7%, n=69), transfemoral amputation (9.5%, n=37), and knee disarticulation (0.8%, n=3). During the index hospitalization, 18.2% (n=71) returned to the OR for amputation-related procedures, with 63.3% (n=45) of these returns being planned. Reamputation at a higher level occurred in 2.6% (n=10) of cases. Overall, 64.4% (n=251) eventually received a prosthesis with functional levels distributed as follows: K1 (10.4%, n=26), K2 (42.6%, n=107), K3 (38.6%, n=97), K4 (0.8%, n=2), and unknown (7.6%, n=19). Time from surgery to prosthetic prescription ranged from 1 to 1320 days (~3.6 years) with mean of 116 days and median of 60 days.

Conclusions: Nearly 90% of initial major lower limb amputations from dysvascular disease occur at or distal to the knee. Approximately two-thirds of patients eventually used a prosthesis with a minority (~39%) achieving K3 or K4 functional levels indicating unlimited community ambulation.