LAUSR

B elow knee amputations (BKA) are the most common type of amputation performed. Over 2 million people live with an amputation in the USA and this year alone over 185,000 amputations will be performed. This will directly contribute to the exorbitant $8.3 billion in associated hospital costs not to mention the significant indirect price incurred given the amputee’s potential inability to continue contributing to the economy due to disability. Almost half of the patients amputated for vascular disease will die in 5 years which is higher than the mortality rates for colon, breast and prostate cancer. Unfortunately, as diabetes and end stage renal disease are on the rise, the number of BKAs performed are only increasing and expected to double by 2050. Even though BKA is a common surgical procedure with significant morbidity and mortality, there is a surprising paucity of data regarding a standardized, optimal perioperative approach to these patients. As a result, the BKA procedure itself, perioperative and immediate postoperative care is dictated in 2020 primarily by the surgeon