Name of the Procedure:

Addition to Lower Extremity, Torsion Control

Common names: Torsion Control Addition, Lower Limb Torsion Adjustment

Technical/Medical term: Straight Knee Joint Torsion Control Addition (HCPCS L2380)

Summary

This procedure involves adding a torsion control mechanism to the lower extremity (e.g., leg) to aid in stabilizing the knee joint. It typically involves the installation of a straight knee joint component to help manage and control rotational forces on the knee.

Purpose

The addition of the torsion control component is used to address issues related to knee instability, such as those caused by ligament injuries, neuromuscular diseases, or congenital deformities. The primary goals are to enhance knee stability, improve mobility, and prevent further joint damage.

Indications

• Chronic knee instability or weakness
• Conditions like multiple sclerosis, polio, or muscular dystrophy affecting lower limb stability
• Post-operative support following knee surgery
• Traumatic injuries leading to knee instability

Preparation

• Patients may be advised to undergo specific diagnostic tests like X-rays or MRI to assess the knee condition.
• Fasting is not typically required.
• Adjustments to medication, particularly anticoagulants, may be necessary.
• Patients should discuss any existing medical conditions or allergies with their healthcare provider.

Procedure Description

1. The patient is positioned comfortably, usually lying down.
2. The targeted knee area is sterilized to prevent infection.
3. Local anesthesia may be administered to numb the area.
4. A controlled incision is made to expose the knee joint.
5. The straight knee joint component with torsion control is precisely attached to the knee.
6. The incision is closed with sutures, and a sterile dressing is applied.
7. The knee is often immobilized using a brace or splint to facilitate healing.

Duration

The procedure typically takes between 1 to 2 hours.

Setting

This procedure is usually performed in a hospital or an outpatient surgical center.

Personnel

• Orthopedic surgeon
• Surgical nurse
• Anesthesiologist (if general anesthesia is used)
• Physical therapist (for post-procedure rehabilitation)

Risks and Complications

• Infection at the surgical site
• Bleeding or hematoma formation
• Nerve damage leading to numbness or weakness
• Loosening or failure of the torsion control component
• Knee stiffness or reduced range of motion

Benefits

• Enhanced knee stability and support
• Improved mobility and reduced risk of falls
• Potential pain relief from chronic knee instability
• Prevention of further knee joint damage

Recovery

• Patients may need to use crutches or a walker initially.
• Physical therapy is often recommended to restore knee function.
• Follow-up appointments to monitor healing and adjust the torsion control component if necessary.
• Recovery time can vary, but most patients resume normal activities within 4 to 6 weeks.

Alternatives

• Physical therapy and strengthening exercises
• Use of non-invasive braces or orthotics
• Medications to manage pain and inflammation
• Alternative surgical procedures like ligament repair or knee replacement

Patient Experience

During the procedure, patients will be under anesthesia so they will not feel pain. Post-procedure, there may be discomfort or pain at the surgical site, typically managed with prescribed pain medication. Swelling and bruising are common but should subside over a few weeks. Patients may feel gradual improvement in knee stability and function within days to weeks, with full benefits realized after complete recovery.

Pain management, including medications and physical therapy exercises, will be part of the post-procedure care to ensure patient comfort and optimal recovery.