Name of the Procedure:

Common Name: Knee-Ankle-Foot Orthosis (KAFO)
Technical Term: L2037 - Knee Ankle Foot Orthosis, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated

Summary

A Knee-Ankle-Foot Orthosis (KAFO) is a custom-fabricated orthopedic device designed to support the knee, ankle, and foot. It is typically made of plastic and may include a single upright bar for extra stability. This orthosis can incorporate joints that either allow or restrict motion at the knee and ankle, depending on the specific needs of the patient.

Purpose

Medical Conditions Addressed: This orthosis is used to treat conditions such as muscular weakness, deformity, joint instability, or paralysis in the lower limbs.
Goals/Outcomes: The primary goals are to provide stability, correct deformities, facilitate walking, and prevent further injury. It aims to improve mobility and enhance the quality of life for patients with lower limb impairments.

Indications

Symptoms/Conditions:

• Muscle weakness or paralysis in the lower limbs
• Joint instability or deformity
• Post-operative protection and support after lower limb surgeries
• Neuromuscular disorders like cerebral palsy or multiple sclerosis Patient Criteria:
• Individuals with significant difficulty in ambulating due to lower extremity issues
• Non-responsive to less intensive orthotic treatments

Preparation

Pre-procedure Instructions:

• Measurement and fitting sessions with an orthotist
• Wearing appropriate clothing for fitting sessions
  Diagnostic Tests:
• Physical examination
• Gait analysis
• Possibly imaging studies like X-rays or MRI to assess bone and joint health

Procedure Description

Steps:

1. Assessment: Initial assessment and measurements by an orthotist.
2. Custom Fabrication: The KAFO is custom-made based on precise measurements.
3. Fitting Appointment: The patient tries on the orthosis, and adjustments are made for comfort and effectiveness.
4. Final Adjustments: Follow-up appointments may be scheduled to make any necessary tweaks. Tools/Equipment:
   
   • Casting materials for custom molds
   • Plastic and metal components of the orthosis Anesthesia/Sedation: Not applicable

Duration

Typical Time: The entire process from assessment to final fitting usually takes several weeks. Each fitting session lasts about one to two hours.

Setting

Performance Location: The procedure is typically conducted in an outpatient clinic or an orthotist's office.

Personnel

Involved Professionals:

• Certified Orthotists
• Physical Therapists
• Sometimes, involvement of an orthopedic surgeon for initial referrals

Risks and Complications

Common Risks:

• Skin irritation or breakdown
• Pressure sores Rare Risks:
• Allergic reaction to materials used Management: Regular follow-up for adjustments and managing any adverse effects.

Benefits

Expected Benefits:

• Improved walking stability
• Enhanced mobility
• Reduced pain
• Prevention of further deformities
  Timeline: Benefits are typically noticeable within a few weeks of proper usage.

Recovery

Post-Procedure Care:

• Regular skin checks for irritation
• Gradual increase in wearing time as advised by the orthotist Recovery Time: Adjusting to wearing the KAFO may take a few weeks, but substantial improvements in function can occur relatively quickly. Restrictions/Follow-ups: Regular follow-up appointments for monitoring and adjustments.

Alternatives

Other Options:

• Ankle-Foot Orthosis (AFO)
• Physical Therapy
• Surgical Interventions Pros and Cons: KAFO provides more support compared to AFO but may be bulkier and harder to get used to.

Patient Experience

During Procedure: No significant discomfort during measurement and fitting. Post-Procedure:

• Initial discomfort may include skin irritation or pressure points
• Pain management through adjustments and proper skin care
• Gradual adaptation to wearing the orthosis, leading to improved comfort and function over time.