Name of the Procedure:

Addition to Lower Extremity, Socket Insert, Knee Disarticulation (Kemblo, Pelite, Aliplast, Plastazote or equal)

Summary

This procedure involves adding a specialized insert to the socket of a lower extremity prosthetic limb at the knee disarticulation level. The insert is made from materials like Kemblo, Pelite, Aliplast, or Plastazote, which provide cushioning and a better fit for the prosthetic.

Purpose

The primary purpose of this procedure is to enhance comfort and function for individuals using a lower limb prosthetic. The insert helps to prevent pressure sores, improve weight distribution, and ensure a snug fit, which enhances the overall use of the prosthetic limb.

Indications

• Patients with a knee disarticulation amputation
• Discomfort or pressure sores with current prosthetic socket
• Poor fit or instability of the prosthetic limb
• Skin irritation or breakdown from the existing prosthetic

Preparation

• No specific pre-procedure fasting or medication adjustments typically required.
• Patients might need to undergo an assessment to measure the limb and identify any specific pressure points.

Procedure Description

1. The prosthetist evaluates the patient's residual limb.
2. Measurements and molds of the limb may be taken for a custom insert.
3. The selected material (Kemblo, Pelite, Aliplast, or Plastazote) is cut to fit the shape and size of the prosthetic socket.
4. The insert is placed within the socket of the prosthetic limb.
5. Adjustments are made to ensure a secure and comfortable fit.
6. The patient tries on the modified prosthetic to confirm proper alignment and comfort.

Duration

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

Setting

The procedure is usually performed in an outpatient clinic specialized in prosthetics and orthotics.

Personnel

• Certified Prosthetist or Orthotist (CPO)
• Prosthetic Technician (if custom fabrication is needed)
• Nurse or medical assistant for patient support

Risks and Complications

• Mild discomfort or pressure during the adjustment phase
• Rare risk of an allergic reaction to the insert material
• Possible need for further adjustments after initial fitting

Benefits

• Improved comfort and fit of the prosthetic limb
• Reduced risk of skin irritation or pressure sores
• Enhanced mobility and function with the prosthetic
• Benefits typically noticeable immediately upon proper fitting

Recovery

• Patients can usually resume normal activities immediately after fitting.
• Follow-up appointments might be necessary to ensure the insert continues to fit well and remains comfortable.
• Monitoring for any signs of pressure sores or skin issues will be advised.

Alternatives

• Use of different padding techniques or materials within the prosthetic socket.
• Adjustments to the prosthetic socket itself without an insert.
• Pros and cons:
  • Alternatives might not provide the same level of customization or comfort.
  • Direct socket adjustments might be more invasive and time-consuming.

Patient Experience

• Patients might feel slight pressure during the initial fitting but should feel increased comfort thereafter.
• Pain management typically involves addressing pressure points within the prosthetic and ensuring proper fitting.
• Over-the-counter pain relievers can be used if there is temporary discomfort during the adjustment period.