Diabetes and PAD investigated in revision rates of amputation

A new study investigating lower extremity amputations in people with diabetes or peripheral arterial disease (PAD) finds that there was a 25 per cent rate of revision surgery.
A research team led by Florian Wanivenhaus, MD, Department of Orthopaedics, University of Zurich, identified 421 patients with either PAD or diabetes.
All patients had undergone a lower extremity primary amputation between 2002-2012. Their medical records were used to assess presence and type of diabetes, diagnosis, duration and treatment.
Overall, there was a 25.2 per cent revision rate among patients. This rate refers to surgery that is conducted as a follow-up to previous surgery. The mean time from amputation to revision was 244 days.
People with type 1 diabetes and type 2 diabetes had a significantly higher rate of revision at a more proximal level compared to patients without diabetes. Patients who underwent revision amputation had a significantly younger mean age than patients who did not undergo revision amputation.
The researchers also concluded that polyneuropathy and diabetic neuropathy were both risk factors for revision amputation.
“Considering the given data, a particular level of amputation cannot be recommended in patients with diabetes mellitus or PAD,” the authors wrote.
“Because of the high prevalence of comorbid conditions in the amputee population, optimisation of each patient’s health by internal medicine specialists is mandatory.”
The findings are published in Orthopedics.