Name of the Procedure:

Below knee prosthesis with molded socket, shin, and SACH (Solid Ankle Cushion Heel) foot
HCPCS Code: L5100

Summary

A Below Knee Prosthesis is a customized medical device designed to replace a missing lower leg, including the shin and part of the foot. It typically consists of a molded socket to fit the residual limb, a prosthetic shin, and a SACH foot.

Purpose

This procedure addresses limb loss below the knee. Its goals are to restore mobility, improve the patient's quality of life, and provide the ability to perform daily activities with greater independence.

Indications

• Traumatic limb loss below the knee
• Congenital limb differences
• Severe infections requiring amputation
• Diabetic foot ulcers or other conditions necessitating lower leg amputation

Preparation

• Consultation with a prosthetist to take measurements and impressions of the residual limb
• Possible diagnostic tests to assess residual limb health
• Instructions on skin care and preparation of the residual limb

Procedure Description

1. Initial Consultation: Measurements and mold of the residual limb are taken.
2. Fabrication: A custom socket is designed to fit the unique shape of the residual limb.
3. Fitting: The prosthetic shin and SACH foot are attached to the socket. Adjustments are made to ensure a comfortable and secure fit.
4. Training: The patient receives gait training and instructions on using the prosthesis.

The procedure involves precise measurement tools, socket molding materials, and the SACH foot mechanism. Anesthesia or sedation is typically not required.

Duration

The entire process, including measuring, fitting, and training, may span multiple appointments over a few weeks.

Setting

The procedure is performed primarily in an outpatient setting such as a prosthetics clinic.

Personnel

• Prosthetist
• Orthopedic specialist
• Physical therapist for post-fitting rehabilitation

Risks and Complications

• Skin irritation or sores on the residual limb
• Improper fit leading to discomfort or mobility issues
• Adjustments may be needed to address misalignment or wear

Benefits

• Improved ability to walk and perform daily activities
• Enhanced quality of life and independence
• Psychological benefits from regaining mobility

Recovery

• Immediate post-fitting, follow-up appointments to adjust the fit as the residual limb changes
• Regular physical therapy sessions for gait training
• Ongoing skin care and maintenance instructions

Alternatives

• Other types of below knee prosthetic feet, such as dynamic response feet or energy-storing feet, which may offer different benefits in terms of activity level and mobility
• Wheelchairs or mobility scooters for those who may not be candidates for prosthetics

Patient Experience

During the fitting process, patients may feel some initial discomfort as they adapt to the new prosthesis. Physical therapy will help in adjusting to the device. Pain management includes over-the-counter pain relief and ensuring a proper socket fit to minimize pressure.