Name of the Procedure:

Addition to Lower Extremity, Test Socket, Above Knee (L5624)

Summary

A test socket addition above the knee is a procedure where a temporary socket is fitted to an artificial limb. This socket allows for adjustments and ensures the final prosthesis will fit comfortably and function effectively.

Purpose

The procedure is designed to address issues of fit and comfort for individuals using a prosthetic limb. The goal is to create a socket that aligns properly with the residual limb and provides optimal function, comfort, and mobility.

Indications

This procedure is typically indicated for:

• Individuals who have undergone an above-knee amputation.
• Patients experiencing discomfort or poor fit with their current prosthetic socket.
• Those needing a trial period with an adjustable socket before committing to a permanent one.

Preparation

Patients may need to:

• Follow specific fasting guidelines if any sedation is involved.
• Adjust medications as advised by their healthcare provider.
• Undergo a physical examination and possibly imaging tests to assess the residual limb.

Procedure Description

1. Assessment: The residual limb is evaluated and measured.
2. Casting/Molding: A cast or digital scan of the limb is created to design the test socket.
3. Socket Fabrication: A temporary socket is made from a lightweight, adjustable material.
4. Fitting Session: The patient tries on the test socket, and adjustments are made to ensure proper fit.
5. Trial Period: The patient uses the test socket for a set period, reporting back any issues for further adjustments.

Tools and equipment include casting materials, digital scanning devices, and fabrication tools. Local anesthesia may be used, particularly if any minor adjustments to the residual limb are required.

Duration

The initial fitting session typically takes 1-2 hours. The entire process, including trial and adjustments, can span several weeks.

Setting

The procedure is usually performed in an outpatient prosthetics clinic or a specialized rehabilitation center.

Personnel

• Prosthetist
• Technician
• Possibly a physical therapist for gait training and functional assessment

Risks and Complications

Common risks include:

• Skin irritation or pressure sores.
• Temporary discomfort.

Rare complications may involve:

• Allergic reactions to materials.
• Infections if skin integrity is compromised.

Benefits

The primary benefit is the creation of a well-fitted socket that enhances comfort and prosthetic function. Patients typically realize these benefits within a few weeks of adjustments and trial use.

Recovery

Post-procedure care involves:

• Regular follow-ups for adjustments.
• Monitoring for skin irritation.
• Guidance on proper limb hygiene and care.

Recovery time varies, but most patients adapt to the test socket within a few weeks. Restrictions may include avoiding high-impact activities initially.

Alternatives

Alternatives include:

• Direct fitting of a permanent socket, which may lack the fine-tuning period of a test socket.
• Use of padding or liners to improve fit temporarily.

The primary advantage of the test socket approach is the ability to make necessary adjustments before finalizing the prosthesis.

Patient Experience

During the procedure, patients might feel mild discomfort during the fitting. Post-procedure, they should expect to report back periodically for adjustments. Pain management is usually minimal, with over-the-counter pain relievers sufficing for any residual discomfort. Comfort measures include frequent fitting checks and adjustments to the socket.