Ewing Amputation (EA) is a new surgical method to help Veterans with Peripheral Artery Disease (PAD) who need a Below Knee Amputation (BKA). PAD is where blood flow to the legs is reduced, often causing pain and difficulty in moving. The study will last for 2 years at the AVAMC, where doctors will use EA to improve Veterans' recovery and mobility. EA is designed to reduce pain and improve balance by creating special nerve connections called AMI (Agonist-Antagonist Myoneural Interface) and RPNI (Regenerative Peripheral Neural Interfaces). These help the muscles and nerves work together better after surgery. EA might help Veterans heal faster and walk better with a prosthetic leg. The study needs 30 Veterans, and they will be checked for 6 months after the surgery. Veterans can join if they have good blood flow, are willing to do rehab, and don't have serious infections.

• The study lasts for 2 years, with 6-month follow-up checks.
• Participants will help test if EA improves healing after BKA.
• EA aims to reduce pain and increase ease of movement with a prosthetic.