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Below-the-Knee Leg Amputation: What to Expect at Home

Your Recovery

A below-the-knee amputation is surgery to remove your leg below the knee. Your doctor removed the leg while keeping as much healthy bone, skin, blood vessel, and nerve tissue as possible.

After the surgery, you will probably have bandages, a rigid dressing, or a cast over the remaining part of your leg (remaining limb). The leg may be swollen for at least 4 weeks after your surgery. If you have a rigid dressing or cast, your doctor will set up regular visits to change the dressing or cast and check the healing. If you have elastic bandages, your doctor will tell you how to change them.

You may have pain in your remaining limb. You also may think you have feeling or pain where your leg was. This is called phantom pain. It is common and may come and go for a year or longer. Your doctor can give you medicine for both types of pain.

You may have already started a rehabilitation program (rehab). You will continue this under the guidance of your doctor or physiotherapist. You will need to do a lot of work to recondition your muscles and relearn activities, balance, and coordination. The rehab can last as long as a year.

You may have been fitted with a temporary artificial leg while you were still in the hospital. If this is the case, your doctor will teach you how to care for it. If you are getting an artificial leg, you may need to get used to it before you go back to work and your other activities. You will probably not wear it all the time, so you will need to learn how to use a wheelchair, crutches, or other device. You will have to make changes in your home. Your workplace may be able to make allowances for you.

Having your leg amputated can be traumatic. And learning to live with new limits can be hard and frustrating. Many people feel depressed and may grieve for their former lifestyle. It's important to understand these feelings. Talking with your family, friends, and health professionals about your frustrations is an important part of your recovery. You may also find that it helps to talk with a person who has had an amputation.

Remember that even though you've lost a limb, it doesn't change who you are or prevent you from enjoying life. You'll have to adapt and learn new ways to do things. But you can still work and take part in sports and activities. And you can still learn, love, play, and live life to its fullest.

Many organizations can help you adjust to your new life. For example, you can go to www.amputeecoalitioncanada.org for information and support.

This care sheet gives you a general idea about how long it will take for you to recover. But each person recovers at a different pace. Follow the steps below to get better as quickly as possible.

How can you care for yourself at home?

Activity

Be active. Talk to your doctor about what you can do. If you are active and use your remaining limb, it will heal faster.
You may shower when your doctor okays it. Wash the remaining limb with soap and water, and pat it dry. You may need help doing this at first.
You may need to adapt your car to your situation before you drive.
You will probably be able to return to work and your usual routine when your remaining limb heals. This can be as soon as 4 to 8 weeks after surgery, but it may take longer.

Diet

You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. Take a fibre supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.

Medicines

Your doctor will tell you if and when you can restart your medicines. The doctor will also give you instructions about taking any new medicines.
If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
Be safe with medicines. Take pain medicines exactly as directed.
- If the doctor gave you a prescription medicine for pain, take it as prescribed.
- If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
If you think your pain medicine is making you sick to your stomach:
- Take your medicine after meals (unless your doctor has told you not to).
- Ask your doctor for a different pain medicine.
If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

Remaining limb care

You may have bandages, a rigid dressing, or a cast on your remaining limb. Your doctor will tell you how to take care of it. Depending on your dressing and the doctor's instructions:
- Check your remaining limb daily for irritation, skin breaks, and redness. Tell your doctor about any problems you see.
- Wash your remaining limb with mild soap and warm water every night. Pat it dry.
If you have a temporary artificial leg, remove it before you go to sleep.

Exercise

Rehabilitation is a series of exercises you do after your surgery. This helps you learn to use your remaining limb and artificial leg. You will work with your doctor and physiotherapist to plan this exercise program. To get the best results, you need to do the exercises correctly and as often and as long as your doctor tells you. Your rehab program will give you a number of exercises to do. Always do them as your therapist tells you.

Other instructions

Preventing contractures is very important. A contracture occurs when a joint becomes stuck in one position. If this happens, it may be hard or impossible to straighten your remaining limb and use an artificial leg.
- Make sure you put equal weight on both hips when you sit. Use firm chairs, and sit up straight.
- Keep your remaining limb flat with your knees straight and your legs together while you are lying on your back.
- Lie on your stomach as much as possible to stretch your hip joint.
- Do not sit for more than an hour or two. Stand, or lie on your stomach now and then.
- Do not put pillows under your hips or knees or between your thighs.
- Do not rest your remaining limb on crutch handles or a wheelchair.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

You passed out (lost consciousness).
You have chest pain, are short of breath, or you cough up blood.

Call your doctor or nurse advice line now or seek immediate medical care if:

You have pain that does not get better after you take pain medicine.
You are sick to your stomach or cannot drink fluids.
You have loose stitches, or your incision comes open.
You have signs of a blood clot in your leg (called a deep vein thrombosis), such as:
- Pain in your calf, back of the knee, thigh, or groin.
- Redness or swelling in your leg.
You have signs of infection, such as:
- Increased pain, swelling, warmth, or redness.
- Red streaks leading from the incision.
- Pus draining from the incision.
- A fever.
You bleed through your bandage.

Watch closely for any changes in your health, and be sure to contact your doctor or nurse advice line if you have any problems.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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Care instructions adapted under license by your healthcare professional. If you have questions about a medical condition or this instruction, always ask your healthcare professional. Healthwise, Incorporated disclaims any warranty or liability for your use of this information.