Lower limb reconstruction surgery

The cost of lower limb reconstruction surgery with Circle Health Group depends on a variety of factors, including the type of surgery you have and where you have it. Your healthcare team will ensure you know the cost of your treatment at every stage of your journey with them, including information on how and when to pay it.

Fixed-price packages

Our fixed-price packages include the cost of your surgery and all appropriate aftercare appointments. However, any pre-surgery diagnostic tests and your consultant's outpatient appointment consultation fee are charged separately.

Spread the cost of your payment

Our flexible payment options help you spread the cost of your payment across a time period that suits you. We offer fixed-term monthly payment plans over one to five years with no deposit required. If you decide to pay over 10 months, you will pay interest-free. If you are paying for a longer period, you will pay 14.9% APR.

Private health insurance

If you have private health insurance, lower limb reconstruction will usually be covered by your provider. Speak to your insurer directly to find out more information on this.

If you have any questions about our fixed-price packages and flexible payment options, you can speak to a friendly member of our advisory team on 0141 300 5009.

If you have suffered trauma to your lower limb, or live with a deformity that was either present from birth or developed later in life, it is possible that you will have some visible symptoms. These may include:

• Your legs not being equal in length
• A leg that isn't fully formed and/or is missing a component
• Swelling and/or bruising on one or both of your legs

Along with these external symptoms, you might have a range of internal symptoms that could mean you require lower limb reconstruction surgery, such as:

• Acute pain in your leg
• Numbness and/or tingling
• Restricted range of movement in your affected leg
• Tenderness
• Inability to walk
• Associated pain in your hip or back

Some conditions lower limb reconstruction surgery is used for include:

Traumatic injuries

If you have suffered a traumatic injury to any part of your leg, we may recommend lower limb reconstruction surgery. Examples of acute traumatic injuries include:

• Open fractures (when the bone pierces through your skin)
• Injuries to your veins
• Crush injuries (an injury caused by a high degree of forced pressure to a part of your body) such as
• Partial amputations
• Severe nerve injuries

Usually, these injuries come as a result of significant traumatic force, such as experiencing a fall, being in a car crash, significant impact while playing a contact sport, or prolonged pressure due to your leg being trapped.

Many of these injuries occur in the tibia (the largest bone in your lower leg) and can lead to infection.¹ This is because swelling develops at the site where fractures have healed at an odd angle, creating high levels of pressure around the tissues (a group of cells that binds organs and body parts together). This infection is known as osteomyelitis, causing further discomfort and increasing the chance that you may need lower leg reconstruction surgery.

Deformities

Deformities occur when one of your limbs are of a different length and/or shape due to a problem with your bone or joint. There are two types of deformity: congenital (present from birth) and acquired (developed later in life). They can be a result of bones not healing correctly following a traumatic injury (known as malunions), growth plates slowing down, bones thinning due to inability to absorb calcium, or stem from conditions that reduce the rate of growth at the ends of your bones (known as enchondromatosis).

It could be that you don't experience any symptoms because of your deformity. However, some complications can occur, such as pain, numbness and/or tingling, stiffness, reduced range of movement, altered posture, or pinched nerves. If you live with a lower limb deformity and have any of these issues, you might need lower limb reconstruction surgery.

Degenerative conditions

Lower limb reconstruction surgery may be required if you have a condition in your leg that causes the cartilage (the tissue that protects your joints) to become worn away, leading to swelling, tenderness, and pain in the affected area. Any condition that negatively influences the function or structure of joints over time is known as degenerative and can lead to reduced mobility and discomfort if not treated.

You will have an initial consultation with us to determine whether you need lower limb reconstruction surgery. Your consultant will begin by getting a full picture of the origin of your lower limb problem, its symptoms, and any past treatment history.

They will then perform a thorough examination to assess the exact severity of your problem and what kind of treatment would be best for you. This involves moving your leg to see when and where you feel pain and how serious the pain is, along asking you to perform a range of exercises to test your range of movement and function in your leg.

Beyond physical examination, your consultant will also take into account how the problem affects your quality of life, including your social life and emotional wellbeing. It is important for us to understand your personal experience of the problem, along with how you feel about the prospect of undergoing lower limb reconstruction surgery, as this allows us to deliver holistic care (a treatment plan that considers your situation as a whole and not just your condition) and tailor treatment to what suits you.

In some cases, such as an open fracture, it can be clear what kind of treatment you require from the outset. On other occasions, like a deformity, further tests may be required. Your consultant may conduct a CT scan - an image test that uses X-rays and a computer to give a detailed scan of the body - or other imaging tests, before making a final decision.

Your consultant may recommend non-surgical treatment, such as physiotherapy, or wearing a corrective brace (a special brace that addresses any incorrect alignments in your leg). If these options don't work, they will most likely decide on a form of lower limb reconstruction surgery that is appropriate for your condition, explaining everything about the treatment to you ahead of booking you in for surgery.

There are several ways you can prepare for lower limb reconstruction surgery, including:

Prepare for a hospital stay

You will need to stay in the hospital for a few days after your operation so that we can monitor how you have responded to the treatment, manage your external fixator (if relevant), and provide adequate pain relief. So, ahead of coming to the hospital, be sure to pack anything that you might need during your time with us, such as loose-fitting clothing or your laptop.

Medication

You will be asked to stop taking any blood-thinning medications one week before your surgery date in order to prevent unwanted bleeding during and/or after your lower limb reconstruction surgery. This includes aspirin, anti-inflammatory medications, or warfarin. Your consultant will explain everything you need to know about medications during your initial consultation.

Stop smoking

You will need to stop smoking at least two weeks before your lower limb reconstruction surgery. Smokers have an increased chance of experiencing breathing and/or heart problems after surgery, and also require more general anaesthetic than a non-smoker. It also threatens the overall quality of your recovery. Please get in touch with your consultant if you have any questions and/or concerns about stopping smoking prior to surgery.

Food and alcohol

Eat a balanced diet with plenty of nutrients in the build-up to the operation. Please also avoid drinking alcohol 48 hours before you visit the hospital. You will also be required to not eat or drink anything past midnight on the day of your surgery.

Prepare your home for your recovery

When you get home from lower limb reconstruction surgery, your mobility will be quite limited. In the early stages of recovery, you will be using crutches and need to rest your leg, so you won't be able to make many quick trips to the shop. So, make sure that you have all the supplies you need at home before the surgery. We'll provide you with crutches to use for the first few weeks, and we recommend that you reorganise your home so that you don't need to travel upstairs too much. Remove any furniture that might be a tripping hazard.

Lower limb reconstruction surgery can involve a number of different procedures, depending on the nature of your issue. The most common treatments involve either rebuilding the affected part of your lower limb with skin or a muscle flap from elsewhere in your body, or removing and/or straightening parts of your bone so that it heals correctly.

This type pf reconstructive surgery is almost always performed under general anaesthetic, which means you'll be asleep for the entire operation and won't feel any pain.

Flap surgery and skin grafts

Your surgeon will assess your condition ahead of deciding which type of skin graft or flap surgery option is most appropriate for you. For small defects on your lower limb, they may just use skin layers to repair the defects and restore the original shape. If the wound is larger, they may use a perforator flap. This is a flap located on your upper leg that consists of skin, tissue, underlying cartilage, and blood vessels.²

An incision will be made, with your surgeon isolating the perforator flap before using special tools to transfer it to the part of your lower limb that has been injured, deformed, or degenerated over time.³ These flaps can treat complex injuries because they have their own blood vessels that can be reconnected through microsurgery (using a microscope). In some cases, your surgeon will also transfer some bone tissue along with the blood vessel.

Bone correction and lengthening

If you have an open fracture, your surgeon will perform a procedure that stabilises your bones and guarantees the surrounding skin and tissues can heal properly. To do this, they may perform an operation that involves using a special tool to remove part of your bone that has been displaced due to physical trauma and/or incorrect healing (known as an osteotomy).

For limb salvage surgery, which is commonly used when you have a tumour in your lower leg, your bone and the tissue will be removed and replaced with an implant, which restores the use and appearance of your limb.

Along with removing some of your bone and tissue, your surgeon may place an external fixator around your leg. This is a metal frame with wires or pins attached to it. These pass through your skin, muscles, and bone, which in turn corrects the shape and position of your bone. It can then be adjusted accordingly as your bone stabilises and lengthens in the right way.

Once the external fixator has been fitted, and your surgeon has made sure your bone and joints are in the correct position, they will clean and close the area - at which point you'll be taken to the post-operative area and woken up from the general anaesthetic.

Everyone recovers from surgery differently depending on factors such as your age, general fitness levels, and why you had surgery in the first place. Generally though, your full recovery from lower limb reconstruction surgery will take up to six months.

One to five days after surgery

After you wake up from surgery, you might feel quite groggy, but this is totally normal as the general anaesthetic wears off. You might also experience some pain, but we will provide you with all the pain relief you need as you recover in hospital. During this time, our team will monitor your wound, graft, or fixator to ensure that it's healing well. We will also provide you with blood-thinning medication to offset the chances of blood clotting after surgery, along with keeping your pin sites clean as you recover.

Bed rest is particularly important in these first few days. You will be advised to remain in bed until the swelling in your leg has gone down. After four days, you can have a shower, but avoid soaking in a bath until the external fixator has been removed.

One to four weeks after surgery

Before leaving hospital, we will give you plenty of advice and training around looking after your external fixator, which requires daily care and maintenance. This includes instructions around keeping pin sites clean. We will provide the supplies that you'll need for this. Our team will also provide you with a pair of crutches or a wheelchair and make arrangements for your discharge needs (transportation, home equipment, etc.).

When you get home, you will need to continue resting and using crutches to get around. Following lower limb reconstruction surgery, giving your bones the chance to stabilise and heal is important, so you may not be allowed to put any weight on your affected leg for several weeks - or until the tissues and/or bones have healed. If you have a desk job, you can return to work after two or three weeks, depending on how you are feeling.

Throughout this recovery period, your designated physiotherapist will regularly run you through breathing and stretching exercises to facilitate healing. They will help also help you walk independently again after four weeks. However, please note that this differs for everyone. You might be on your feet sooner than that, or it could take a little longer.

One to six months after surgery

In most cases, you can start unaided walking again - under the guidance of your physiotherapist - after about a month. The process of full rehabilitation following lower limb reconstruction surgery is a long one; it can take months to recover full strength and range of movement in the affected area. Your physiotherapist will run you through all the exercises you need to return to full mobility, adapting the treatment programme in accordance with how you're feeling and progressing.

Exercises that you'll do with your physiotherapist include:

• Continuous passive motion (prevents stiffness)
• Muscle strengthening exercises (not until five to six months)
• Range of motion exercises
• Restricted weight bearing

If you have an external fixator, this usually comes off after around four months, but can be on for longer.

As is the case with any surgery, complications with lower limb reconstruction surgery can sometimes occur, but this is rare. Your consultant will walk you through all the risks beforehand and respond to any questions and/or concerns you might have ahead of the surgery.

General complications of any operation

• Pain
• Bleeding
• Infection of the surgical incision
• Unsightly scarring
• Blood clots
• Difficulty passing urine
• Chest infection
• Heart attack or stroke

Specific complications of lower limb reconstruction surgery

• Joint stiffness
• Numbness
• Pain in your neck, back, arms, or legs (pseudarthrosis)
• Hematoma (build-up of blood under your skin)
• Seroma (build-up of fluid under your skin)
• Damage to underlying important structures
• Failure of the reconstruction (graft or flap loss)
• Permanent loss of range of movement or strength of the limb

When you choose to go private with Circle Health Group, you can expect:

• Flexible appointment times and locations to fit with your schedule and preferences
• Ability to choose which hospital and consultant suit your needs
• Personalised, consultant-led treatment plans tailored to you
• Comfortable and safe private facilities maintained by established multidisciplinary teams
• Private cosy ensuite rooms as standards and delicious healthy meals
• Affordable, fixed-price packages with aftercare included
• Flexible payment options to help you spread the cost of your care

If you would like to learn more about this lower limb reconstruction surgery, book your appointment online today or call a member of our team directly on0141 300 5009.

Content reviewed by Circle in-house team in November 2022. Next review due November 2025.

1. Limb Reconstruction Surgery, NHS (Liverpool University Hospitals)
2. Surgical Reconstruction of the Lower Extremity, UpToDate
3. Lower Limb Reconstruction Surgery, Hip2Knee Clinic
4. Perforator Flaps for Reconstruction of Lower Limb Defects, NIH
5. Limb Salvage Surgery, NIH