A prospective randomized comparison of healing in Gritti-Stokes and through-knee amputations.

Twenty-two patients with a median age of 79 years had 24 amputations about knee joint level. The patients were randomised to undergo either Gritti-Stokes or through-knee amputations. In two-thirds of limbs transcutaneous oxygen was less than 4.65 KPa (35 mmHg) or there were no audible Doppler signals at the ankle, indicating that a below-knee amputation would have been at risk of failing to heal, and in the remainder an amputation at the knee joint was considered the preferable site for a variety of reasons. Nine of 12 (75%) Gritti-Stokes amputations underwent uncomplicated primary healing compared with only 2 of 12 (17%) through-knee procedures (P = 0.04). Two through-knee amputations required revision to above the knee (17%) while all Gritti-Stokes amputations healed. Three patients in each group became mobile on a prosthesis, the remainder being bilateral amputees or unable to manage an artificial limb.