Name of the Procedure:

Knee Ankle Foot Orthosis (KAFO): Full Plastic, Custom Fabricated
Common name(s): KAFO, Orthotic Brace
Technical/Medical term: L2038

Summary

A Knee Ankle Foot Orthosis (KAFO) is a custom-fabricated brace designed to support and stabilize the knee, ankle, and foot. It is constructed from durable plastic and can accommodate various joint movements, including free motion of the knee and multi-axis ankle motions.

Purpose

KAFOs are used to address conditions that result in weakness, instability, or deformity of the knee, ankle, and foot. The brace aims to enhance mobility, improve gait, and provide support, preventing further musculoskeletal damage.

Indications

• Muscle weakness or paralysis (e.g., due to stroke or nerve damage)
• Joint instability or deformity (e.g., arthritis, polio)
• Conditions affecting gait and mobility (e.g., cerebral palsy, post-polio syndrome)
• Post-surgical rehabilitation requiring immobilization and support

Preparation

• A thorough physical examination and gait analysis by a healthcare professional.
• Imaging studies like X-rays or MRIs to assess bone and joint conditions.
• Custom fitting session to create a model for the orthosis.

Procedure Description

1. Assessment: Initial evaluation of the patient’s needs and physical condition.
2. Casting/Impression: A cast or 3D scan of the leg is taken to ensure a custom fit.
3. Fabrication: The orthosis is molded from durable plastic based on the impression.
4. Fitting: The patient returns for a fitting session to make adjustments for comfort and function.
5. Education: Instructions on how to wear, adjust, and care for the KAFO.

Duration

• Fabrication and fitting appointments may span several weeks.
• Individual sessions vary but typically last 1-2 hours.

Setting

• Outpatient clinic or specialized orthotics facility.

Personnel

• Orthotist (specialist in designing and fitting orthotic devices)
• Physical therapist (for gait training and functional use)
• Physician (for initial referral and ongoing medical evaluation)

Risks and Complications

• Skin irritation or pressure sores
• Discomfort or improper fit
• Muscle atrophy from prolonged use
• Possible need for adjustments or repairs

Benefits

• Enhanced stability and support for weak or unstable joints
• Improved gait and mobility
• Prevention of further musculoskeletal damage
• Increased confidence in walking and reduced fall risk

Recovery

• Gradual adjustment period to get accustomed to wearing the KAFO.
• Follow-up appointments for adjustments.
• Physical therapy sessions to maximize mobility and function.
• Long-term use might be necessary depending on the condition.

Alternatives

• Ankle-Foot Orthosis (AFO) for less extensive support.
• Physical therapy alone for muscle strengthening.
• Surgery for structural corrections.
• Walking aids such as canes or walkers.

Patient Experience

• Initially, the orthosis might feel heavy or cumbersome.
• Mild discomfort is common as the patient acclimatizes to the new brace.
• Pain management strategies, such as using padding and regular adjustment clinics, help enhance comfort.
• Most patients experience significant improvements in stability and mobility within a few weeks of regular use.