Abstract
PAD (peripheral arterial disease) is the cause of 60 to 66% of the lower amputations in the elderly population in Japan. In the past, most patients with PAD were treated with trans-femoral amputation. However, recent progress in endovascular treatment and a multidisciplinary approach, along with the widespread recognition of the importance of preserving the knee joint when selecting the amputation level have lead to an increase in the numbers of trans-tibial amputation. Transtibial amputation is the most preferable level of amputation from the aspect of obtaining a better functional outcome. However, there has been no increase in the rate of successful prosthetic rehabilitation outcome even in trans-tibial amputees from the past to date. It appears to have been due to the lack of effective post-amputation rehabilitation strategies. Human resources to be able to manage post-amputation rehabilitation are also lacking.
