HealthDay News — During the past decade, the use of lower extremity amputations in Medicare patients has declined markedly, and the use of orthopedic treatments for diabetic foot ulcers has increased sharply, researchers found.

The proportion of lower extremity amputations per 100,000 Medicare enrollees decreased 28.8% from 2000 to 2010, whereas use of orthopedic treatments for diabetic foot ulcers, such as Achilles tendon release and total contact casting, increased 143.4% during the same time period, Daniel A. Belatti and Phinit Phisitkul, MD, of the University of Iowa in Iowa City, reported in Foot & Ankle International.

The findings are based on data from the Medicare Part B claims database for volume and reimbursement of all codes designating lower extremity amputations (hip and below), as well as a selection representing orthopedic treatments for diabetic foot ulcers. 

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The largest decline occurred in amputations for the most proximal levels, and the smallest decline was for the most distal locations, the researchers found. 

“Clearly, continued success in preventing lower limb amputations, and limiting those that do occur to more distal levels, will be an uphill battle,” the researchers wrote. “Future work is needed to rigorously demonstrate best practices in preventing LEA and to identify definitively the causes behind recent declines.”


  1. Belatti BA, Phisitkul P. Foot & Ankle International. 2013; 34(7):923-931.