Expert: Scott Anderson - 9/30/2009

Question
My father is hard to fit. He is 69 years old and has an above the knee amputation. He was recently operated on for a second time for a bone spur. He is worse off now than before. It turns out there might have been some tearing. A muscle might not be positioned right. There is a nerve issue and general  skin wear at the top of the stump. Aside from surgical interventions is there any cutting edge prosthetics or therapies that you could suggest? If not do you know of any online or other resources where i might find some new innovation or common sense. I would like him to be able to walk more than two blocks without suffering.
Thanks

Answer
Research the ELEVATED VACCUM SYSTEMS.  They are offered by several manufacturers (ottobock, ohio willow wood, velocity labs, jim smith sales); consult your prosthestist for more detailed information and/or getting a hands on sample.

With regard to pain and tearing.  Absolutely normal within a year to 2 years, depending on patient healing rate and pain tolerance.  You have in essence cut a 10"+ incision over bone and meat then reattached it to other muscle, bone and nerves.  Muscle is made of thousands of fibers that bleed then heal.  The issue is that if a patient is too stagnant post operatively the tissue becomes adhered (sticks to itself among other areas of wound)then becomes scab-like.  Although inside, the scab can tear and rip.  Massage therapy tends to be useful for this type of issue.  Unfortuneately, if the actual amputation left a jagged edge to the bone then the scarring and ripping will be a constant issue.

Lastly, if your father is OUT OF SHAPE (overweight, not active, history of complications)then ths above mentioned issues are generally worse and take longer to heal.  I would recommend consulting a vascular surgeon and/or pain management physician.  goodluck.