Name of the Procedure:

Addition to Lower Extremity, Polycentric Knee Joint for Custom-Fabricated Knee Ankle Foot Orthosis (HCPCS L2387)

Summary

In simpler terms, this procedure involves adding a special type of knee joint called a polycentric knee joint to a custom-made leg brace. This leg brace extends from the knee down to the foot, providing stability and support for people with leg weaknesses or conditions affecting their lower limb function.

Purpose

The procedure is designed to help individuals with mobility issues related to the knee and lower leg. The main goals are to improve stability while walking, reduce pain and discomfort, and enhance overall mobility and independence for the patient.

Indications

• Conditions like osteoarthritis, ligament injuries, or muscular dystrophy that affect knee stability.
• Patients who require a custom-fabricated knee ankle foot orthosis (KAFO) for enhanced mobility support.
• Individuals struggling with knee hyperextension or instability.

Preparation

• Patients may be advised to adjust certain medications, especially blood thinners.
• A thorough medical and physical evaluation is necessary.
• Measurements of the patient's lower extremity will be taken to custom-fit the orthosis.

Procedure Description

1. The patient is evaluated to check the specific alignment and dimensions of their leg.
2. A mold of the patient's leg is often created to ensure a precise fit for the custom orthosis.
3. The polycentric knee joint, which mimics the natural movement of the knee, is incorporated into the KAFO design.
4. The final orthosis is fitted and adjusted to the patient to ensure comfort and functionality.
5. Instructions on how to wear and care for the device are provided.

Duration

The fitting and adjustment process typically takes a couple of hours, although the creation of the custom orthosis may take several weeks.

Setting

This procedure is typically performed in an orthotics and prosthetics clinic or a specialized medical center.

Personnel

• Orthotists who specialize in making and fitting orthotic devices.
• Physical therapists may also be involved in the assessment and fitting process.
• Medical physicians oversee the entire procedure to ensure it meets medical standards.

Risks and Complications

• Skin irritation or sores from the orthosis.
• Discomfort due to improper fit.
• Limited mobility if the device is not used correctly.
• Possible need for frequent adjustments.

Benefits

• Increased knee stability and reduced risk of falls.
• Improved walking ability and mobility.
• Enhanced comfort compared to traditional knee support devices.
• Benefits can often be noticed immediately after proper fitting and adjustment.

Recovery

• Minimal recovery time; patients can usually resume normal activities soon after fitting.
• Regular follow-ups may be necessary to adjust the orthosis based on the patient's comfort and response.

Alternatives

• Standard off-the-shelf knee braces.
• Surgical interventions for knee stability, such as ligament repair.
• Physical therapy programs aimed at strengthening the knee and lower leg muscles.
• Each alternative comes with its own set of pros and cons, such as varying levels of support, comfort, mobility, and cost.

Patient Experience

• Patients might feel an initial period of adjustment while getting used to the new device.
• Pain management with over-the-counter pain relief if needed.
• Regular maintenance and checks to ensure the orthosis stays comfortable and effective.

This comprehensive insight ensures patients know what to expect and are prepared for each step in the process while understanding the benefits and potential risks of adding a polycentric knee joint to their orthosis.