Name of the Procedure:

Common name: Above-Knee Prosthesis Medical term: Molded Socket Prosthesis with SACH Foot and Single Axis Knee, Endoskeletal System (HCPCS Code: L5321)

Summary

This procedure involves fitting a custom-made prosthetic leg for patients who have undergone an above-knee amputation. The prosthesis includes a molded socket, a SACH (Solid Ankle Cushioned Heel) foot, and a single-axis knee joint, all constructed within an endoskeletal system.

Purpose

The primary purpose of this prosthesis is to restore functional mobility and improve the quality of life for individuals who have lost a leg above the knee. The goals are to enable the patient to perform daily activities, enhance balance and stability, and promote independence.

Indications

The procedure is indicated for patients with:

• Above-knee amputations due to trauma, disease, or congenital conditions.
• Adequate physical condition to support the use of a prosthetic leg.
• The need for improved mobility and functional activity levels.

Preparation

Patients are typically required to:

• Undergo a comprehensive medical assessment to ensure they are suitable candidates.
• Participate in a personalized prosthetic fitting session.
• Adhere to any specific instructions from their healthcare provider, which might include managing their weight, maintaining the residual limb health, and preparing for mobility training.

Procedure Description

1. Initial Assessment: Detailed evaluation of the residual limb's shape and condition.
2. Casting or Scanning: Taking a mold or digital scan of the residual limb to create a precise socket fit.
3. Fabrication: Constructing the molded socket and assembling it with the SACH foot and single-axis knee.
4. Fitting: Ensuring the prosthesis fits comfortably and making any necessary adjustments.
5. Training: Instructing the patient on how to use and care for the prosthesis.

The prosthesis is customized for each patient using advanced materials and technologies. No anesthesia or sedation is required.

Duration

The entire process, from initial assessment to final fitting, can take several weeks, but each fitting session typically lasts 1-2 hours.

Setting

The procedure is performed in a specialized prosthetics clinic or a rehabilitation center equipped with the necessary facilities.

Personnel

The healthcare team may include:

• Prosthetists
• Physical therapists
• Occupational therapists
• Rehabilitation physicians

Risks and Complications

Risks are generally minimal but can include:

• Skin irritation or breakdown at the residual limb site.
• Discomfort or improper fit requiring further adjustments.

• Difficulty adapting to the new prosthesis.

  Management involves regular follow-ups and adjustments to the prosthesis.

Benefits

The benefits include:

• Improved mobility and ability to perform daily activities.
• Enhanced balance and stability.
• Increased independence.

These benefits can be experienced soon after successful fitting and training.

Recovery

Post-procedure care includes:

• Regular cleaning and inspection of the prosthesis.
• Skin care to prevent irritation around the socket area.

• Continuing physical therapy to adapt to the prosthesis.

  Expected recovery time varies, but most patients adapt within a few weeks to a few months.

Alternatives

Other options may include:

• Knee-disarticulation prostheses
• Above-knee prostheses with different types of foot and knee components (e.g., microprocessor-controlled knees).

Each alternative has its benefits and drawbacks. For example, microprocessor-controlled knees might offer more dynamic control but can be more expensive.

Patient Experience

Patients might feel initial discomfort or unfamiliarity with the prosthesis. Over time, with proper training and adjustments, most patients report significant improvement in comfort and function. Pain management can include over-the-counter pain relievers and ongoing support from the healthcare team.