Name of the Procedure:

Addition to Lower Extremity, Suction Suspension, Above Knee or Knee Disarticulation Socket (HCPCS Code: L5652)

Summary

The procedure involves attaching a suction suspension system to a prosthetic socket for individuals with above-knee or knee disarticulation amputations. This system helps to secure the prosthetic limb to the residual limb, enhancing stability and comfort.

Purpose

The primary aim is to provide a secure and comfortable attachment of the prosthetic limb to the residual limb, allowing for improved mobility and function. This procedure addresses issues found in amputees who face difficulties with prosthetic limb fit and stability.

Indications

• Individuals who have undergone above-knee amputation or knee disarticulation.
• Patients experiencing discomfort, instability, or poor fit with their current prosthetic attachment system.
• Individuals needing a more secure and reliable prosthetic limb attachment for improved mobility.

Preparation

• No specific fasting is required.
• The patient should inform their healthcare provider about all current medications and any allergies.
• A thorough assessment, including the residual limb’s condition and current prosthetic fit, is performed before the procedure.

Procedure Description

1. Assessment: The current prosthetic setup and residual limb are evaluated.
2. Customization: The prosthetic socket is modified or a new one is created to include a suction suspension system.
3. Attachment: A one-way valve, a vacuum pump system, or other suction mechanisms are affixed to the modified or new socket.
4. Fitting: The patient’s residual limb is inserted into the socket, and the suspension system is activated to create suction, securing the prosthetic limb in place.

Tools and Equipment

• Prosthetic socket materials (e.g., carbon fiber, plastic)
• Suction suspension system components (valves, pumps)
• Custom fitting tools

Anesthesia

• Typically, no anesthesia or sedation is required as it is a non-invasive, mechanical adjustment procedure.

Duration

The procedure typically takes 1-2 hours, depending on the complexity of customization required.

Setting

• Outpatient clinic or specialized prosthetic fitting center.

Personnel

• Certified prosthetist
• Prosthetic technician
• Occasionally, a physical therapist for gait training post-procedure

Risks and Complications

• Skin irritation or sores at the point of contact
• Potential difficulty in achieving proper suction
• Possible adjustments required for optimal fit
• Rarely, infections at the contact point if not well-maintained

Benefits

• Enhanced stability and comfort of the prosthetic limb
• Improved mobility and functional use of the prosthetic
• Reduced risk of the prosthetic limb becoming loose or falling off

Recovery

• Immediate post-procedure gait training may be necessary.
• Care instructions include regular cleaning of the contact areas and proper maintenance of the suction system.
• Typically, patients experience improved prosthetic function within days.

Alternatives

• Pin-lock suspension system
• Liner-based suspension system
• Traditional belt and harness suspension

Pros and Cons of Alternatives:

• Pin-lock systems: secure but can cause skin irritation.
• Liner-based suspension: comfortable but less stable.
• Belt and harness: adds weight and can be cumbersome.

Patient Experience

• During Procedure: Patients may feel tugging or pressure as the prosthetic is adjusted, but little to no pain.
• Post-Procedure: Some initial discomfort or adjustment-period soreness, which can be managed with over-the-counter pain relievers. Most patients quickly adapt to the improved stability and comfort of their prosthetic limb.

Pain management and comfort measures include padding, alignment adjustments, and possibly short-term use of analgesics.