Name of the Procedure:

Addition to Lower Extremity Orthosis, Knee Control, Knee Cap, Medial or Lateral Pull, for Use with Custom Fabricated Orthosis Only (HCPCS Code: L2800)

Summary

This procedure involves adding a specialized component to a custom-made lower extremity orthosis (leg brace) to provide better control of knee movement. This additional part, which helps to manage the position and motion of the kneecap, can be adjusted to pull medially (towards the center of the body) or laterally (away from the center).

Purpose

This procedure aims to improve knee stability and alignment in patients with knee instability, patellar misalignment, or other related conditions. The goal is to enhance comfort, reduce pain, and improve overall mobility.

Indications

• Knee instability or ligament insufficiency
• Patellar subluxation or dislocation
• Post-surgical support for knee ligament reconstruction
• Chronic knee pain related to improper kneecap tracking

Preparation

• No special preparation is needed.
• The patient may need to undergo initial assessments to measure and fabricate the custom orthosis.
• Follow any specific instructions from the healthcare provider, such as ensuring the custom orthosis fits properly before the addition.

Procedure Description

1. Initial Evaluation:
   A healthcare professional assesses the patient's knee condition and the existing custom lower extremity orthosis.

2. Component Selection:
   The appropriate knee cap control component (medial or lateral pull) is chosen based on the patient's specific knee needs.

3. Attachment of Component:
   The chosen component is securely attached to the existing custom orthosis to ensure proper knee cap alignment and control.

4. Adjustment and Fitting:
   Adjustments are made to ensure the added component provides the desired knee cap control without causing discomfort.

5. Instruction:
   The patient is instructed on how to wear the modified orthosis and any necessary adjustments they can make.

Duration

The procedure typically takes 30-60 minutes.

Setting

The procedure is performed in an orthopedic clinic or a specialized bracing and orthotic workshop.

Personnel

• Orthotists
• Physical therapists
• Orthopedic specialists

Risks and Complications

• Mild discomfort or irritation at the site of the added component
• Possible misalignment if the component is not properly adjusted
• Rare risk of skin abrasions or pressure sores

Benefits

• Improved knee stability and alignment
• Reduced pain and discomfort
• Enhanced mobility and functionality
• Benefits are usually realized immediately after the fitting is complete

Recovery

• Patients can generally resume normal activities immediately but should follow any activity restrictions advised by their healthcare provider.
• Regular follow-up appointments may be necessary to ensure the orthosis continues to fit and function as intended.

Alternatives

• Physical therapy for knee stabilization exercises
• Other types of knee braces or orthoses, including off-the-shelf options
• Surgical interventions for severe cases of knee instability

Patient Experience

• During the procedure, patients may feel some discomfort during fitting and adjustments.
• After the procedure, patients should experience improved knee support and comfort. Any mild initial discomfort typically subsides as they get used to the new component.
• Pain management, if needed, can include over-the-counter pain relievers and adjustments to the orthosis for better comfort.