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ABSTRACT Revision to a higher amputation level is a common procedure most often necessitated by injury to the residual limb, infection, ulceration, incision dehiscence, or critical limb ischemia. It is possible that a patient could actually increase functional status after an amputation revision, and this report documents the functional status of an individual before and after an amputation revision from the transtibial level to the transfemoral level due to critical limb ischemia and suggests possible causes of his success. Three assessments, the Locomotor Capabilities Index with a 5-point scale (LCI5), Instrumental Activities of Daily Living (IADL), and Amputee Mobility Predictor with a prosthesis (AMPpro), were administered 1 month before the revision and 3 months later. His LCI5 score increased by 10 points, the AMPpro score increased by 9 points, and the IADL status remained constant. There are several factors that likely contributed to this patient’s success as a transfemoral amputee. First, this patient was 49 years old, and his first amputation was the result of a trauma, so he had a statistical advantage over most amputees. Second, the patient was highly motivated and well supported by his family. Finally, the patient was treated by a multidisciplinary team of prosthetists, physicians, and physical therapists who regularly reviewed his goals and progress. With each of these factors in place, the patient actually increased his functional status after the amputation revision.

Maintaining Function After an Amputation Revision