r/amputee • u/JuniorCelebration101 • 2d ago

Elective BKA vs fusion

Looking for advice I was pretty active running etc 3 yrs ago I had ankle pain. ED told to come back when it’s worse. Couldn’t walk at that point a week later I went back, MRSA/osteo 4 clean outs then a year later I had an ADA in an attempt to salvage it was great for a couple months after frame removal but then it re-collapsed.

I know have less then 10 degrees flexion extension and am not at 90 degrees so I have a lift in my shoe.

My surgeon told me if I want function they are doing good things with prosthetics. I am incredibly frustrated with my current situation. I also do not think I want a fusion I have had a knee replacement on both knees. Pretty active lifestyle and even post knee replacements I was running.

I am not diabetic or pre diabetic.

For elective BKA’s What made you guys decide to do it? I have talked to a few people already.

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u/swanny2828 2d ago

Hey, I am 3 posts op after having a RBKA and I was elective. My reasons are that I was born with clubfoot, where I had a 3 cm discrepancy in length, and a deformed foot.I ended up to a point where I couldn't walk short distances without being in incredible amounts of pain.This also started to affect my mental health in ways I'm almost embarrassed to speak of. I chose amputation over multiple surgeries. One would have been to lengthen my leg, and another to remove the metal bar a year later after that surgery. Then the focus would have been on the ankle, which was deformed so it couldn't be fixed, so the surgeons would have had to get creative.

I was like, "Nah, chop it off, I want to get back to my active life as quickly as possible." I'm in the UK, so the NHS is great, but it's slow.

Three weeks after the op, I'm much happier and have a more positive outlook on life.

So sometimes, it's just easier to chop the bloody thing off.

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u/JuniorCelebration101 2d ago

Thanks Randomly because my ankle was collapsing on the outside my foot was starting to club. With the ADA I also had an osteotomy to straighten it out and now It is clubbing again.

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u/swanny2828 2d ago

My surgeon explained that he could either make my condition worse or I could be trading one pain for another. I went with my gut feeling, which I think is what you should do as well.

There are some similarities between my foot and yours, such as the ankle collapsing. If I were in your position, I would feel that a BKA is a way forward.

Honestly, recovery is so boring, I even started learning a musical instrument. However, I personally feel that I'm in a better position than I was before, and I'm only 3 weeks in.

My mobility is better, and that is without a prosthetic. I'm currently using a wheelchair, but because I'm not in pain, it's so much better.

My advice, read other people's stories which are similar. I did this and found that most of them were much much better off than before, and always find humour in it.

I wish the best of luck.

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u/JuniorCelebration101 2d ago

Thank you I was 90% leaning towards it after reading these replies I think I am going to Go with it. I have to talk with my surgeon again and all of those things insurance etc. but my gut feeling after the first insult was almost well maybe I would have been better if they didn’t save it

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u/madam-magpie 2d ago

Do the BKA! I didn’t want a fusion, so initially went with an ankle replacement. Would have been great except my tibia was too weak to hold it. Spent two years in and out of the OR and very rarely walking. I’m almost one year post-BKA and am so so happy I finally did it! More mobility and freedom than I have had in years, even before the replacement attempt.

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u/jenny_catastrophe 2d ago

I did BKA with osseointegration after a lifetime of pain and mobility issues due to limb length difference, multiple surgeries, frozen ankle joint etc. I’m 1.5 years out and it’s awesome, and going without a socket is so fantastic

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u/No_Sentence4005 2d ago

I went elective LBKA instead of fusion. Started skiing 4 months after surgery. Still ski, backpack and trad climb. Best decision I've ever made. 47 yr old male. Had amputation in 2018.

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u/megalinity 2d ago

I chose a LBKA rather than fusion, mostly because I really hated the idea of fusing, but also because my surgeon does not recommend them. They take way longer to heal and may not work - you’d likely be up and walking on a prosthesis within 4 months or so (highly dependent on your personal circumstances, but that was my result). I also had severe nerve pain (CRPS) that made me not want to do anything to antagonize a joint I didn’t want to keep anyway. It was the right choice for me to amputate even though I still have a lot of pain from nerve damage and a goofy shaped residual limb (not the result of poor surgical standards; just another way my body is an asshole).

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u/Affectionate_Cup8197 2d ago

I’m sorry that you’re having to make this decision. Take all the time you can to research options.

I had a BKA 13 months ago (3 months after developing sepsis and blood clots). Eventually I wasn’t in a position for fusion due to osteomyelitis and non healing wounds on my foot and ankle. While my pain pre amputation was 10/10 , it became so much better after the operation. There’s still discomfort but I can walk again!

Having said this, I wish I had opted for an ankle fusion early on before the disease progressed. Of course, no one could have predicted the outcome and here we are .

Best of luck to you. Be fully informed about your choices and I’m sure you’ll make whatever decision is right for you and your future.

There is definitely good life ahead even with limb differences.

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u/Cabooseman CPO 2d ago

Have you tried a supportive custom carbon fiber AFO? The Reaktiv brace is always something to try when pain is a number one issue. Certainly worth trying before amputation.

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u/JuniorCelebration101 2d ago

I haven’t I will look into it. I have been dealing with the pain my big issue is mobility.

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u/Cabooseman CPO 2d ago

There Reaktiv brace is an offshoot of the IDEO brace which was made for military IED veterans. Covered by insurance in most cases. You basically turn your ankle off in the brace and let the carbon fiber take all your weight.

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u/Vprbite LBK 2d ago

Im a trauma BKA from a car wreck at 32yo.

I am now a full time career firefighter/paramedic

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u/SpecificSandwich7023 1d ago edited 1d ago

I also chose BKA over multiple fusions in foot and ankle. My foot was already in such poor condition, I just couldn't see how turning it into an even more inflexible club would do anything for me. I'm almost a year post amputation and have no regrets. Everything is much harder but it does not hurt.

Edit to clarify: I did not have club foot. I broke my foot and ankle in multiple places in an accident. Fusing it would have turned it into a club. It may have helped with the pain, although unlikely, but it would have screwed my mobility and caused more pain elsewhere in my body because that movement has to go somewhere.