One hundred and three bilateral lower-extremity amputees were evaluated
to determine their eventual ambulation level. Of thirty-eight bilateral
above-the-knee amputees, two with traumatic amputation were prosthetically
rehabilitated, while none of the thirty-five with dysvascular amputation
were so rehabilitated. Twenty-two of the dysvascular above-the-knee
amputees were wheelchair ambulators and thirteen were bedridden. Prosthetic
rehabilitation has been successful for traumatic bilateral above-the-knee
amputees but has never been successful for our dysvascular bilateral
above-the-knee amputees. The goal for dysvascular bilateral above-the-knee
amputees is wheelchair ambulation. Of twenty-one patients with combinations
of above-the-knee and below-the-knee amputations, five were prosthetically
rehabilitated, including four dysvascular amputees; ten were wheelchair
ambulators; and six were bedridden. Of forty-four patients with bilateral
below-the-knee amputation, thirty-five were prosthetically rehabilitated
and the remaining nine were wheelchair ambulators. Since the success rate
for prosthetic rehabilitation is higher for amputees with combination
above-the-knee and below-the-knee amputation than for those with bilateral
above-the-knee amputation, and again increases for those with bilateral
below-the-knee amputation, the significance of preserving the knee joint,
even a single knee, cannot be overemphasized.