Name of the Procedure:

Common name(s): Knee Orthosis, Rigid Brace Technical term: Knee orthosis, without knee joint, rigid, custom fabricated (HCPCS Code: L1834)

Summary

A knee orthosis is a type of brace designed to support and immobilize the knee. This specific type, without a knee joint and rigid in nature, is custom-made to fit the patient's leg.

Purpose

The knee orthosis aims to provide support and stability to the knee, particularly useful for treating injuries or conditions that require immobilization to heal. The expected outcome is the reduction of pain, improved stability, and prevention of further injury.

Indications

• Severe knee ligament injuries
• Post-operative stabilization
• Arthritis or other degenerative joint diseases
• Chronic instability or deformities

Preparation

• No fasting or medication adjustments generally required
• Diagnostic imaging, such as X-rays or MRIs, may be performed to assess the knee's condition
• Measurements of the leg to create a custom fit

Procedure Description

1. Assessment: The medical provider will assess the knee's condition and perform necessary imaging.
2. Measurement: Precise measurements of the leg are taken to ensure the orthosis fits perfectly.
3. Fabrication: A custom orthosis is fabricated using rigid materials according to the measurements.
4. Fitting: The orthosis is fitted to the patient’s leg, adjustments are made for comfort, and instructions for use are provided.

Tools and equipment include measurement tools, materials for orthosis fabrication (such as plastic, metal, or composite materials), and adjustment tools.

Duration

The fitting and initial assessment typically take about 1 to 2 hours.

Setting

Orthopedic clinic or a specialized outpatient center

Personnel

• Orthopedic surgeon or physician
• Orthotist (specialist in making and fitting braces)
• Nurse or medical assistant

Risks and Complications

• Skin irritation or pressure sores
• Discomfort if the orthosis is not properly fitted
• Limited mobility
• Rarely, allergic reactions to materials used

Managing complications may involve adjusting the fit, using cushions or padding, and close monitoring by healthcare providers.

Benefits

• Pain relief and increased stability
• Prevention of further injury
• Improved knee function over time Benefits are often realized within a few days to weeks of regular use.

Recovery

• Follow-up appointments to monitor progress and adjust the orthosis as needed
• Instructions on cleaning and maintenance of the orthosis
• Possible physical therapy to complement the use of the orthosis
• Full recovery and stabilization might take several weeks to months, depending on the underlying condition

Alternatives

• Soft knee braces
• Surgical intervention
• Physical therapy alone Pros and cons of alternatives:
• Soft braces offer more flexibility but less support.
• Surgery may be more definitive but involves more risks and longer recovery time.
• Physical therapy might not be sufficient for severe instability.

Patient Experience

During the procedure, patients may experience slight discomfort from measurements and fitting. Post-procedure, the orthosis may feel cumbersome initially but will become more comfortable with use. Pain management strategies include the use of ice packs initially and over-the-counter pain relief if needed. Regular follow-up will help address any discomfort and ensure optimal fit and function.