Name of the Procedure:

Addition to Lower Extremity, Socket Insert, Below Knee

Common Name(s): Below-Knee Prosthetic Socket Insert
Technical/Medical Terms: Kemblo, Pelite, Aliplast, Plastazote Socket Insert (HCPCS Code L5655)

Summary

This procedure involves adding a specialized insert to a below-the-knee prosthetic socket. The insert is made from materials like Kemblo, Pelite, Aliplast, or Plastazote, which provide cushioning and improve the fit and comfort of the prosthetic limb.

Purpose

The procedure aims to enhance the comfort, fit, and functionality of a below-the-knee prosthetic limb. It helps in reducing friction, distributing pressure evenly, and preventing skin irritation or sores. The desired outcome is improved mobility and comfort for the patient.

Indications

• Patients experiencing discomfort or skin issues due to an ill-fitting prosthetic socket.
• Individuals with a below-the-knee amputation who require improved prosthetic fit.
• Patients whose prosthetic limb needs an upgrade or adjustment for better support and comfort.

Preparation

• Patients may need to consult with their prosthetist for an assessment.
• No specific fasting or medication adjustments are typically required.
• Measurements of the residual limb will be taken to customize the insert.

Procedure Description

1. Assessment: The prosthetist evaluates the current prosthetic fit and identifies pressure points or areas of discomfort.
2. Material Selection: Based on the assessment, the appropriate insert material (Kemblo, Pelite, Aliplast, or Plastazote) is chosen.
3. Customization: The insert is customized to fit the contour of the patient’s residual limb.
4. Fitting: The insert is placed into the prosthetic socket, and adjustments are made to ensure an optimal fit.
5. Final Check: The prosthetist ensures that the insert provides adequate cushioning and comfort.

Tools & Equipment: Measurement tools, prosthetic socket, various insert materials (Kemblo, Pelite, Aliplast, Plastazote).

Anesthesia or Sedation: Not applicable, as this is a non-invasive adjustment.

Duration

The entire procedure usually takes about 1 to 2 hours, including assessment and fitting.

Setting

This procedure is typically performed in a prosthetist's office or an outpatient clinic.

Personnel

• Prosthetist
• Prosthetic technician (optional)

Risks and Complications

• Rare risk of the insert not fitting properly, requiring additional adjustments.
• Potential for initial discomfort as the patient adjusts to the new insert.
• Very low risk of allergic reaction to insert materials.

Benefits

• Improved comfort and fit of the below-the-knee prosthetic.
• Reduced risk of skin irritation and pressure sores.
• Enhanced mobility and prosthetic performance.
• Benefits can be realized immediately after fitting, with ongoing improvement.

Recovery

• Patients can resume most normal activities immediately.
• Follow-up appointments may be needed to ensure the insert remains comfortable and effective.
• Patients should monitor for any signs of irritation or pressure and report them to their prosthetist.

Alternatives

• Replacing the entire prosthetic socket.
• Using different prosthetic liners or padding materials.
• Pros: A less invasive and quicker solution compared to replacing the entire socket.
• Cons: May require periodic adjustments or replacements of the insert.

Patient Experience

During the procedure, patients will undergo measurements and fittings, which may involve some minor adjustments but should not be painful. Afterward, patients might feel an immediate improvement in comfort. Any minor discomfort as they adjust to the new insert can be managed with over-the-counter pain relief if needed.