Monday, May 20, 2013
Double Total Leg Amputation
im 18 yrs old and have had 5 hip surgeries including a hip fusion. bc of my hip fusion i have torn ligaments in both my knees (both continue to "back-knee" nomatter the amount of pt i do). my spine is curving bc i limp and the way i have been forced to sit for the past 7 yrs. im in constant pain for 10 yrs that even codine and narcotics dont make a dent in. my drs tell me i can get my hip replaced but it wont get rid of my artritis and opther orthopedic problems. my parents and family agree that atleast gettin my l leg amputated at the hip would solve alot of my physical problems. but my right hip is slipping again bc of the pressure and accomidations ive had to make. my question is it even possible to recive an amputation with the problems im having or am i "screwd"?
You ask a number of important questions, which would most appropriately be directed to your orthopedic surgeon. If you have already discussed all these questions but still feel you need further information, consider obtaining a second orthopedic opinion.
Your discussion should include clarifying the reason you have had 5 hip surgeries - despite the fact you still fall within the pediatric age group. It is unclear if all your hip surgeries have been on one hip or if instead you have had surgery on both hips (no need to provide further information, since NetWellness is not a medical consultation service). The reason why a hip fusion and not a hip replacement was performed should also be discussed. Usually a hip fusion is performed only if a hip replacement is not an option. It would be difficult if not impossible to perform a hip replacement on the same side where a hip fusion has been performed previously.
You mentioned having "other orthopedic problems" which appear to involve both knees and your spine, among perhaps other areas. Amputation at the hip (referred to as "hip disarticulation") should only be considered if all other options have been exhausted. Significantly greater energy expenditure is required to walk following a hip disarticulation, particularly if using a hip disarticulation prosthesis (approx. 100% more energy per unit distance) as opposed to hopping on crutches (roughly 50% more energy per unit distance). However, wearing a prosthesis permits weight-bearing to be divided (hopefully fairly equally) between your intact and prosthetic leg and may reduce or eliminate the need for using such hand-held gait aids as a crutch or cane. Whereas hopping on crutches without a prosthesis would result in 100% of your body weight being borne by your remaining lower limb - which you mentioned already has knee and hip problems, so this would be expected to aggravate those conditions and also place considerable forces on both upper limbs, particularly your shoulders and wrists. This could potentially cause problems to develop in these areas.
Finally, since you indicate your pain levels have not been adequately controlled, if you have not already done so, you may wish to discuss with your physician the appropriateness of having you consult with a pain medicine physician.
Brian L Bowyer, MD
Clinical Associate Professor
Physical Medicine & Rehabilitation
College of Medicine
The Ohio State University