Name of the Procedure:

• Common Names: Custom knee brace, Custom knee orthosis
• Technical/Medical Term: Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated (L1844)

Summary

A knee orthosis (brace) that is custom-made to fit the patient’s thigh and calf, providing adjustable support for knee movement, including flexion and extension. This orthosis helps in controlling side-to-side and rotational movements and can be adjusted to correct alignment issues if needed.

Purpose

• Medical Conditions: Arthritis, ligament injuries, knee joint instability, post-surgical recovery
• Goals/Outcomes: To stabilize the knee joint, control movement, reduce pain, and aid in rehabilitation and functional mobility.

Indications

• Symptoms: Knee pain, instability, swelling
• Conditions: Ligament injuries (ACL, PCL, MCL, LCL), osteoarthritis, post-operative support, rotational control needs
• Patient Criteria: Individuals with significant knee instability, deformities, or those requiring precise movement control and support during rehabilitation.

Preparation

• Pre-Procedure Instructions: No specific preparation needed; wearing comfortable clothing for measurements.
• Assessments: Physical examination, possible imaging studies (X-rays, MRI) to assess the extent of knee issues and determine brace specifications.

Procedure Description

1. Measurement: A qualified professional takes detailed measurements of the thigh, knee, and calf.
2. Customization: The measurements are used to fabricate a brace that fits precisely to the patient's leg and addresses their specific needs.
3. Fitting: The custom-fabricated orthosis is fitted on the patient. Adjustments are made to ensure comfort and proper alignment.
4. Instructions: The patient is taught how to wear and adjust the brace, including how to manage the flexion and extension settings.

• Tools/Equipment: Measuring tape, casting mold (if needed), various orthotic materials (plastic, metal hinges, padding)
• Anesthesia: None required.

Duration

• Measurement and Fitting: Approximately 1-2 hours over one or two appointments.
• Fabrication: Typically takes a few days to a couple of weeks, depending on the complexity.

Setting

• Location: Orthotic and prosthetic clinic, outpatient rehabilitation clinic.

Personnel

• Healthcare Professionals: Orthotist, physical therapist, physician overseeing the treatment plan.

Risks and Complications

• Common Risks: Discomfort or irritation at contact points, initial difficulty in adjusting to the brace.
• Rare Risks: Skin breakdown, improper alignment leading to muscle strain.
• Management: Follow-up visits to adjust the fit, patient education on skin care.

Benefits

• Expected Benefits: Increased knee stability and support, pain reduction, improved mobility, and enhanced rehabilitation outcomes.
• Timeline: Benefits are often noticeable immediately upon proper fitting, with ongoing improvement as the patient adjusts.

Recovery

• Post-Procedure Care: Regular use as instructed, skin monitoring for irritation.
• Recovery Time: No downtime; immediate resumption of normal activities with the orthosis.
• Restrictions/Follow-Up: Follow-up appointments for adjustments, as needed.

Alternatives

• Treatment Options: Physical therapy, standard (non-custom) knee braces, surgical interventions.
• Pros/Cons: Custom braces offer tailored support but are more expensive. Standard braces are less costly but might not provide optimal stabilization. Surgery could be more definitive but involves higher risks and longer recovery.

Patient Experience

• During the Procedure: Minimal discomfort during measurement and fitting.
• Post-Procedure: Adjustment period to get used to the brace. Initial relief from knee instability and pain.
• Pain Management: Generally minimal pain; over-the-counter pain relievers if there is initial discomfort. Regular follow-ups ensure continued comfort and effectiveness.