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Total knee replacement in a transtibial amputee
  1. Ahmed Elsayed1,
  2. Douglas Allan2,
  3. Peter Samuel Edward Davies2 and
  4. Stephen Dalgleish2
  1. 1University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
  2. 2Trauma and Orthopaedic Surgery, Ninewells Hospital and Medical School, Dundee, UK
  1. Correspondence to Dr Ahmed Elsayed; ahmedelsayed{at}


We present the case of a man in his 60s with a transtibial amputation (TTA) undergoing total knee replacement (TKR) for symptomatic osteoarthritis (OA). It is unusual to develop OA in the ipsilateral knee to TTA; and while it is postulated that this is because patients preferentially load their unaffected limb to protect the TTA-sided knee, there is also the ability to offload specific knee compartments through prosthetic adjustment. When planning TKR in such patients, it is important to consider several technical challenges in order to prevent a poor outcome. The literature is sparse with evidence to guide decision-making, and this case report and literature review aims to summarise our preoperative planning and intraoperative technique, which ultimately resulted in a good outcome.

  • Orthopaedics
  • Orthopaedic and trauma surgery

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  • Contributors All authors had substantial contributions to designing the case report. AE and PSED wrote the initial draft of the manuscript. The manuscript was then critically revised for important intellectual content by DA, PSED and SD. AE and DA were responsible for submission and final manuscript revision. SD provided the final approval of the version to be published.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.