Experiences of living with through-knee or above-knee amputation: a qualitative interview study

PURPOSE: Through-knee amputation (TKA) preserves a longer residuum and enables end-weight bearing and prosthetic self-suspension, unlike above-knee amputation (AKA). Despite this, TKA is rarely performed. The lived experience of individuals with TKA remains unexplored. PARTICIPANTS AND METHODS: This cross-sectional qualitative study used semi-structured interviews to explore the experiences of 20 community-dwelling individuals with TKA or AKA, sampled for sex and mobility from two UK limb centres. Reflexive thematic analysis was used to compare and contrast groups. RESULTS: "Hide or Pride" examines why some individuals choose to conceal or display their amputations, highlighting the unique challenges each group faces. "Staying Positive" emphasises the importance of an optimistic outlook, particularly in the TKA group who feel relieved to have retained more of their leg. "Getting On With It" addresses changes in activities, falls, phantom sensations, and prosthetic issues. It notes frustrations in the TKA group about their longer thigh in tight spaces and the comfort challenges faced by the AKA group. CONCLUSION: TKA may be a viable option from the patient perspective. Understanding shared and distinct experiences of TKA and AKA can inform clinical decisions about amputation level and rehabilitation. The diverse sample enhances the transferability of findings to similar high-income contexts.