Name of the Procedure:

Knee-Ankle-Foot Orthosis (KAFO), also known as Full Plastic Double Upright Orthosis, with or without Free Motion Knee and Ankle, Custom Fabricated (HCPCS Code: L2036).

Summary

A Knee-Ankle-Foot Orthosis (KAFO) is a custom-made, full plastic brace designed to support the knee, ankle, and foot. It can be constructed with or without the ability to allow free movement in the knee and ankle joints. This orthosis is tailored to fit an individual's specific anatomy and needs.

Purpose

This orthosis is used to provide stability, support, and proper alignment to the lower limb, particularly for individuals with severe muscle weakness, joint instability, or deformities. The main goals are to improve mobility, enhance gait efficiency, and prevent further complications or deformities.

Indications

• Severe muscle weakness or paralysis in the lower limb (e.g., due to polio, spinal cord injury, or muscular dystrophy).
• Joint instability or deformities in the knee, ankle, or foot.
• Rehabilitation following surgery or trauma.
• Neuromuscular disorders affecting limb function.

Preparation

• Patients may need to undergo a thorough physical examination and evaluation by an orthopedic specialist.
• Imaging studies (e.g., X-rays, MRIs) may be required to assess the extent of the deformity or instability.
• Custom casting or 3D scanning of the limb is often performed to ensure a precise fit.

Procedure Description

1. Assessment: A comprehensive evaluation is conducted to understand the patient's specific needs.
2. Casting/Scanning: A custom mold or digital scan of the leg is taken to create a precise model.
3. Fabrication: The orthosis is crafted from durable plastic materials, incorporating double uprights for additional support.
4. Fitting: The custom orthosis is adjusted to ensure proper fit and comfort.
5. Training: The patient is trained on how to put on, take off, and use the orthosis effectively.

Duration

The fitting and adjustment process during the final appointment can take approximately 1-2 hours. The entire fabrication process from assessment to delivery might span several weeks.

Setting

This procedure is typically performed in an orthopedic clinic or a specialized orthotics and prosthetics facility.

Personnel

• Orthopedic specialist
• Certified orthotist
• Physical therapist (for rehabilitation and training)

Risks and Complications

• Skin irritation or pressure sores from improper fit.
• Joint stiffness or discomfort.
• Possible requirement for periodic adjustments or modifications.

Benefits

• Enhanced stability and alignment of the lower limb.
• Improved gait and mobility.
• Prevention of further deformities or complications.
• Enhanced quality of life due to increased independence.

Recovery

• There may be a short adjustment period where the patient acclimates to wearing the orthosis.
• Regular follow-up appointments to monitor fit and function.
• Potential physical therapy to improve mobility and strength.

Alternatives

• Ankle-Foot Orthosis (AFO) for less severe cases.
• Surgical interventions in some cases.
• Physical therapy and strength training programs. Each alternative has its pros (less invasive, shorter recovery) and cons (may not provide as much stability or support).

Patient Experience

• Initial discomfort or difficulty in adjusting to wearing the orthosis.
• Potential improvement in mobility and comfort within a few weeks.
• Pain management during the adjustment phase might include over-the-counter pain relief medications.

Patients should expect to see significant improvements in stability and mobility, which could lead to a more active and independent lifestyle. Regular consultations with healthcare providers ensure that the orthosis continues to meet the patient's needs effectively.