Name of the Procedure:

Addition to Lower Extremity, Socket Insert, Multi-Durometer, Below Knee (HCPCS Code: L5665)

Summary

This procedure involves adding a specialized insert to a prosthetic socket for a below-knee amputee. The insert, known as a multi-durometer insert, is designed to provide improved comfort and function by using materials with varying levels of hardness.

Purpose

The procedure is performed to enhance the fit and comfort of a below-knee prosthetic socket. It aims to address issues such as pressure points, instability, and skin irritation, thereby improving the patient’s mobility and overall quality of life.

Indications

• Below-knee amputation
• Discomfort or pain from current prosthetic socket
• Skin irritation or sores
• Difficulty maintaining stable gait or balance

Preparation

• No specific fasting or medication adjustments usually required.
• Evaluation by a prosthetist to assess the fit and condition of the current prosthetic socket.
• Medical history and physical examination to ensure suitability for the modification.

Procedure Description

1. A prosthetist will begin by assessing the existing prosthetic socket and the patient’s residual limb.
2. Measurements and molds of the residual limb may be taken to ensure a precise fit.
3. The multi-durometer insert is fabricated, typically combining softer materials for areas needing more cushioning and firmer materials for structural support.
4. The insert is then placed inside the prosthetic socket, with adjustments made to ensure a comfortable and supportive fit.
5. The patient will try on the modified prosthetic to ensure proper alignment and comfort, with further adjustments made as necessary.

Duration

The procedure usually takes about 1-2 hours, including assessment, fitting, and initial adjustments.

Setting

The procedure is typically performed in an outpatient prosthetics clinic.

Personnel

• Certified Prosthetist
• Technician (if on-site fabrication is required)
• Sometimes a Physical Therapist for gait training

Risks and Complications

• Minor skin irritation or pressure sores if the fit is not perfect
• Temporary discomfort during the adjustment period
• Rarely, allergic reactions to the materials used

Benefits

• Improved comfort and reduced pain
• Enhanced mobility and stability
• Decreased risk of skin irritation or sores
• Better overall prosthetic function

Recovery

• Immediate use of the modified prosthetic is usually possible.
• Patients may need a short period of adjustment to get used to the new insert.
• Follow-up appointments may be scheduled to ensure the fit is maintained and to make any necessary adjustments.

Alternatives

• Standard single-durometer socket insert
• Custom-molded liners
• Different prosthetic socket designs
• Each alternative comes with its own set of benefits and limitations, which should be discussed with a prosthetist.

Patient Experience

• During the procedure, patients might feel pressure as molds or measurements are taken.
• Post-procedure, there may be a brief adjustment period where minor discomfort can be managed with over-the-counter pain relief if necessary.
• Most patients report significant improvement in comfort and mobility within a few days of the insert being added.

This markdown text provides a structured overview of the Addition to Lower Extremity, Socket Insert, Multi-Durometer, Below Knee procedure (L5665) in a clear and comprehensive manner.