Dr. Michael Dillon is an Associate Professor in Prosthetics and Orthotics, and currently serves as the Head of Department of Physiotherapy, Podiatry, and Prosthetics and Orthotics within the School of Allied Health, Human Services, and Sports at La Trobe University. Dr. Dillon also serves as an Editor-in-Chief of Prosthetics and Orthotics International. Dr. Dillon is a graduate of La Trobe University and during the early part of his career, he worked as a prosthetist/orthotist in public hospitals as well as private practice. Dr. Dillon obtained a PhD in biomechanics and biomedical engineering from Queensland University of Technology prior to commencing his academic career at Hong Kong Polytechnic University and later La Trobe University. Dr. Dillon has taught across a diverse range of curriculum areas including transfemoral prosthetics, foot-ankle orthotics, and critical appraisal subjects that look to help students and experienced clinicians become informed consumers of the research evidence. Dr. Dillon’s research is similarly diverse given studies in areas of biomechanics, epidemiology, quality of life and outcomes after lower limb amputation. In recent years, Dr. Dillon has led a small international collaboration to develop shared decision making resources that can help clinicians, and those facing the prospect of amputation, engage in meaningful conversations to help inform difficult decisions about amputation surgery.
Many people facing the prospect of amputation surgery are anxious about the likely outcomes, and concerned about whether they’ll walk again. Unfortunately many people seen unaware that about 40% of people will experience significant complications in the months following dysvascular partial foot amputation and 25% will need another amputation on the same limb within the year. It is often assume that having the least invasive amputation surgery will result in the best outcomes despite evidence showing that mobility and quality of life outcomes are comparable in the years that follow.
In our interviews with people about their experience of partial foot amputation, we were surprised by how poorly informed many people were about the surgery itself and the likely outcomes. We also recognised the many challenges helping to inform these difficult decisions given the impact that many pain medication and anxiety can have on cognition and recall. If people are to help people make a truly informed decision about amputation surgery, and plan for the likelihood of complications down-the-road, we need to find better ways to help inform these difficult decisions. In this talk, we’ll look at the outcomes of dysvascular partial foot and transtibial amputation based on a recent systematic review, what people have told us about the experience of limb loss, and discuss shared decision making as one approach to help inform decisions about amputation surgery and help people prepare for the likely challenges ahead.