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Lower extremity amputations can lead to very functional limbs with good quality of life, mobility and return to employment. The greater length of the residual limb requires less energy expenditure for ambulation and produces greater physical component scores. Through knee amputation have traditionally been associated with a greater stump pain and therefore many patients received above knee amputations to prevent this pain. Newer techniques at preventing stump and neuroma pain including TMR and RPNI may allow more successful through knee amputations, which require less energy expenditure for ambulation than above knee ones.