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Addition to lower extremity, below knee, molded supracondylar suspension ('pts' or similar)

HCPCS code

Name of the Procedure:

Addition to Lower Extremity, Below Knee, Molded Supracondylar Suspension (L5670)

Summary

This procedure involves fitting a custom-molded supracondylar suspension system below the knee. It is designed to enhance the fit and function of a lower extremity prosthesis by adding a snug, supportive suspension just above the knee.

Purpose

  • Medical Conditions: Used primarily in patients with lower limb amputations.
  • Goals: To improve the stability and comfort of a below-knee prosthetic limb. It also aims to prevent the prosthesis from slipping during movement.

Indications

  • Symptoms: Instability, discomfort, or loosening of the below-knee prosthetic limb.
  • Criteria: Patients who require additional support for their below-knee prosthesis due to socket fit issues or active lifestyle.

Preparation

  • Instructions: No special preparations like fasting are necessary. However, patients may be asked to bring their existing prosthesis and possibly wear loose-fitting clothing for easy access.
  • Diagnostics: A detailed fitting assessment will be performed to ensure the suspension system is custom-molded to the patient’s anatomy.

Procedure Description

  1. Assessment: A prosthetist will evaluate the existing prosthesis and the residual limb.
  2. Casting/Molding: A cast or mold of the patient's residual limb will be taken just above the knee.
  3. Fabrication: The custom-molded suspension is created based on the mold.
  4. Fitting: The suspension system is attached to the below-knee prosthesis.
  5. Adjustments: Any necessary adjustments are made to ensure a secure and comfortable fit.
  • Tools and Equipment: Molding materials, prosthetic components, and fitting tools.
  • Anesthesia: Typically not required as the procedure is non-invasive.

Duration

The entire process, including assessment, molding, fitting, and adjustments, typically takes 1-2 hours.

Setting

The procedure is usually performed in a prosthetic clinic or outpatient setting.

Personnel

  • Prosthetist
  • Prosthetic technician
  • Possibly an orthopedic surgeon (if advanced adjustments are required)

Risks and Complications

  • Common Risks: Minor skin irritation or pressure sores, which can usually be managed by adjustments.
  • Rare Risks: Improper fit leading to discomfort or worsening mobility, which may require a re-molding or additional adjustments.

Benefits

  • Stability: Improved prosthesis stability during walking or physical activities.
  • Comfort: Enhanced comfort by preventing the prosthesis from moving or slipping.
  • Functionality: Better overall function and confidence in mobility.

Benefits are often realized immediately after correct fitting, though final adjustments may be needed.

Recovery

  • Care: Regular monitoring of the skin and limb for any signs of irritation or pressure points.
  • Recovery Time: Immediate use is generally possible; however, follow-up visits for adjustments are typically scheduled.
  • Restrictions: None specific, though patients should follow any activity recommendations provided by the prosthetist.

Alternatives

  • Other Options: Suction suspension systems, pin/lock systems, or alternative prosthetic designs.
  • Pros and Cons: Suction systems may offer similar stability but could be harder to don and doff. Pin/lock systems are easy to use but might not provide the same level of socket intimacy or comfort.

Patient Experience

  • During Procedure: Generally, the procedure is pain-free, but some discomfort might arise during the molding process.
  • Post-Procedure: Patients may initially experience mild skin irritation as they get used to the new suspension system, but this typically resolves with proper wearing and adjustments.
  • Pain Management: Any discomfort is usually managed with simple measures like adjusting the fit or using protective liners inside the prosthetic socket.

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