Name of the Procedure:

Addition to Lower Extremity, Below Knee, Acrylic Socket
Common names: Acrylic Below Knee Socket Addition
Technical/Medical term: HCPCS Code L5629

Summary

This procedure involves attaching an acrylic socket to a lower extremity prosthesis, specifically for individuals with amputations below the knee. The acrylic socket ensures a custom fit, enhancing comfort and mobility.

Purpose

The addition of an acrylic socket addresses issues related to the fit and comfort of a prosthesis for below-knee amputees. The goal is to provide a snug, custom fit that allows for improved mobility and functionality of the prosthetic limb.

Indications

The procedure is indicated for patients with:

• Below-knee amputations.
• Discomfort or issues with their current prosthetic socket.

• Need for a custom-fitted prosthetic solution.

  Suitable candidates are typically those who require individualized adjustments for their prosthetic devices to enhance comfort and usability.

Preparation

• The patient should discuss their medical history and any concerns with their healthcare provider.
• No special pre-procedure instructions such as fasting are usually required.
• A thorough physical examination and potentially imaging studies like X-rays may be conducted to aid in the custom fit.

Procedure Description

1. Assessment: The medical professional assesses the residual limb for any abnormalities and fits.
2. Casting: A mold or digital scan of the residual limb is taken to create a custom socket.
3. Fabrication: The acrylic socket is crafted based on the mold/scan.
4. Fitting: The fabricated socket is then fitted onto the prosthetic limb, adjustments are made as necessary.
5. Final Adjustments: Final touches ensure maximum comfort and functionality.

Tools and equipment used include molds, casting materials, digital scanners, and acrylic materials.
Anesthesia or sedation is typically not needed for this procedure.

Duration

The procedure generally takes several hours, depending on the complexity of the fitting and adjustments required.

Setting

This procedure is typically performed in a specialized prosthetics and orthotics clinic.

Personnel

• Prosthetist/Orthotist
• Prosthetic technician
• Occasionally, a physical therapist may be involved for gait training.

Risks and Complications

While generally safe, some risks include:

• Pressure sores or discomfort due to improper fit.
• Skin irritation or allergies to the acrylic material.
• Need for readjustments or refitting if initial fitting is not ideal.

Benefits

Expected benefits include:

• Improved comfort and fit of the prosthetic limb.
• Enhanced mobility and functional use of the prosthesis.
• Benefits are usually realized immediately after adjustments.

Recovery

• There is minimal physical recovery needed.
• Patients may need a short period to adapt to the new socket.
• Follow-up appointments ensure the socket remains comfortable and functional.

Alternatives

Alternatives may include:

• Traditional prosthetic sockets made of different materials like silicone or carbon fiber.
• The alternative options may offer different comfort levels and durability.

Patient Experience

Patients may experience some initial discomfort or pressure as they adapt to the new socket. Adjustments by the prosthetist can address these issues. Pain management typically involves over-the-counter pain relievers if needed, and comfort measures are emphasized during the fitting process.