Name of the Procedure:

Addition to knee joint, disc or dial lock for adjustable knee flexion, each joint
Common Name(s): Adjustable Knee Flexion Lock, Disc Lock Addition
Medical Term: HCPCS Code L2425

Summary

This procedure involves adding a component to the knee joint to help control and adjust the knee's flexion (bending) angle. This adjustment mechanism, often a disc or dial lock, allows for customizable knee positioning, which can be particularly beneficial for individuals with mobility issues.

Purpose

The procedure aims to enhance knee functionality and stability. It is primarily used in patients with conditions that affect knee movement, such as arthritis or those recovering from knee surgery. The goal is to improve mobility, reduce pain, and provide support during rehabilitation.

Indications

• Chronic knee pain from arthritis or other degenerative diseases.
• Recovery from knee surgery needing controlled joint movement.
• Knee instability or weakness.
• Patients who require fine-tuning of knee joint angles for walking or standing.

Preparation

• Patients may be advised to fast for a few hours if sedation is required.
• Adjustments to current medications might be necessary.
• A pre-operative assessment to check overall health, including imaging tests like X-rays or MRIs of the knee.

Procedure Description

1. Anesthesia: Local anesthesia or sedation may be used.
2. Incision: A small incision is made near the knee joint.
3. Attachment: The disc or dial lock mechanism is securely attached to the knee joint.
4. Adjustment: The lock is adjusted to the desired angle of knee flexion.
5. Closure: The incision is closed with sutures or surgical staples.
6. Post-op Assessment: The functionality and comfort of the knee joint are checked.

Tools and Equipment: Locking mechanism (disc or dial), surgical instruments, possibly imaging equipment to guide placement.

Duration

The procedure typically takes about 1-2 hours.

Setting

The procedure is usually performed in a hospital, outpatient surgical center, or specialized orthopedic clinic.

Personnel

• Orthopedic Surgeon
• Surgical Nurse
• Anesthesiologist (if sedation is used)
• Radiologist (if imaging is required during the procedure)

Risks and Complications

Common Risks:

• Infection at the surgical site
• Temporary pain and swelling
• Incomplete or partial locking mechanism function

Rare Risks:

• Deep vein thrombosis (DVT)
• Nerve damage
• Component malfunction requiring revision surgery

Benefits

• Improved knee stability and function
• Reduction in pain
• Enhanced mobility and ability to perform daily activities
• Customizable knee movement post-surgery

Recovery

• Patients may need to rest and avoid strenuous activities for a few weeks.
• Follow-up appointments to adjust the lock mechanism and monitor healing.
• Physical therapy may be recommended to strengthen the knee.
• Full recovery typically takes 4-6 weeks, depending on individual health factors.

Alternatives

• Physical therapy and exercise to strengthen the knee without surgery
• Pain management through medication or injections
• Other types of knee braces or orthotic devices
• Knee replacement surgery for more severe cases

Pros and Cons of Alternatives:

• Physical Therapy: Less invasive but may not be sufficient for severe cases.
• Medications: Provides pain relief but doesn't address joint stability.
• Other Braces: Less customizable, may not offer the same level of adjustment.
• Knee Replacement: More invasive with a longer recovery period but may be needed in severe cases.

Patient Experience

During the Procedure:

• If local anesthesia is used, minimal pain and discomfort.
• If sedation is required, the patient will be comfortable and not remember the procedure.

After the Procedure:

• Some pain and swelling around the knee, manageable with medications.
• Gradual improvement in knee stability and movement.
• Physical therapy and rehabilitation exercises to enhance recovery.

Pain management will include prescribed medications and possibly ice packs to reduce swelling. Comfort measures such as elevation of the leg and support bandages may also be recommended.