Name of the Procedure:

• Additions to Lower Extremity, Total Contact, Above Knee or Knee Disarticulation Socket
• Commonly known as Above-Knee Prosthetic Socket Addition or AK Prosthetic Socket Addition

Summary

This procedure involves the customization and addition of a total contact socket for a prosthetic limb designed for patients who have undergone an above-knee amputation or knee disarticulation. The total-contact socket ensures a precise fit and comfortable support for the prosthetic limb.

Purpose

• Medical Conditions: Primarily addresses the needs of patients who have undergone above-knee amputation or knee disarticulation.
• Goals: To provide a comfortable and secure fit for the prosthetic limb, ensuring optimal function, balance, and mobility for the patient.

Indications

• Specific Symptoms: Loss of limb due to trauma, congenital conditions, or disease.
• Patient Criteria: Candidate for this procedure includes those with above-knee amputations or knee disarticulations who are transitioning to a prosthetic limb.

Preparation

• Pre-procedure Instructions: No specific fasting required. Patients should maintain regular nutrition and hydration.
• Diagnostic Tests: Assessment for proper limb fitting, imaging studies if necessary, and possibly gait analysis.

Procedure Description

1. Custom Molding: A cast or digital scan of the residual limb is taken.
2. Design: The custom socket is designed based on the mold and patient’s specific anatomy.
3. Fabrication: Socket is created using materials such as lightweight plastics or carbon fiber.
4. Fitting: The socket is fitted and adjusted on the patient's residual limb.
5. Testing: The patient tests the socket for comfort and fit; adjustments are made as necessary.

• Tools/Equipment: Casting materials, digital scanning devices, fabrication tools.
• Anesthesia: Not typically required.

Duration

The overall process, from initial molding to final fitting, can take several weeks. Single fitting sessions typically last 1-2 hours.

Setting

Majority of the procedure is performed in a prosthetics clinic or specialized outpatient facility.

Personnel

• Prosthetist: Specializes in designing and fitting prosthetic limbs.
• Physical Therapist: Aids in ensuring proper alignment and gait during the fitting process.
• Supporting Staff: Assist during measurements, fittings, and adjustments.

Risks and Complications

• Common Risks: Skin irritation, pressure sores, or discomfort from improper fit.
• Rare Risks: Skin breakdown, infection, or allergic reactions to materials.
• Management: Adjustments to socket fit, wound care, and patient education.

Benefits

• Expected Benefits: Enhanced mobility, improved comfort, and better quality of life.
• Timeframe: Benefits often realized immediately after proper fitting, with continued improvement over weeks of usage and adjustments.

Recovery

• Post-procedure Care: Regular follow-ups for adjustments, skin care education.
• Recovery Time: Most patients adapt within a few weeks with gradual improvement in function.
• Restrictions: Minimal, though initial use may involve limited activity to ensure adaptation.

Alternatives

• Other Options: Standard prosthetic sockets without total contact, elastic or suction-suspension prosthetics.
• Pros and Cons: Total contact sockets typically provide better comfort and function but may require more frequent adjustments for optimal fit compared to standard options.

Patient Experience

• During Procedure: Minimal discomfort during molding and fitting sessions.
• After Procedure: Initial period of adjustment with possible minor discomfort. Pain management includes proper socket fitting and addressing any issues promptly.
• Comfort Measures: Use of cushioning liners, incremental wearing schedule to prevent skin issues.

With proper care and professional guidance, patients can look forward to a significant improvement in their mobility and overall well-being.