Name of the Procedure:

Addition to Lower Extremity, Below Knee / Above Knee Suspension Locking Mechanism (Shuttle, Lanyard, or Equal), Excludes Socket Insert (HCPCS Code: L5671)

Summary

The procedure involves adding a suspension locking mechanism—using a shuttle, lanyard, or similar device—to a prosthetic limb for the lower extremity (below knee or above knee). This locking mechanism helps secure the prosthetic limb to the residual limb, improving stability and comfort for the user. Note that this addition does not include the socket insert.

Purpose

This procedure aims to enhance the security and functionality of prosthetic limbs for individuals with lower limb amputations. The primary goals are to improve the fit of the prosthetic limb, preventing it from slipping off, and to help distribute weight more evenly, thereby enhancing mobility and overall comfort.

Indications

• Individuals with lower limb amputations (either below the knee or above the knee)
• Patients experiencing instability or discomfort due to improper fitting of their current prosthetic limb
• Cases where the residual limb shape or soft tissue does not securely hold the prosthetic socket

Preparation

• No specific fasting or major dietary restrictions
• Patients may need to ensure the residual limb is clean and free from open wounds or infections
• A fitting assessment and consultation with a prosthetist to determine the most suitable type of suspension mechanism

Procedure Description

1. The prosthetist evaluates the residual limb and the existing prosthetic socket.
2. An appropriate suspension locking mechanism (shuttle, lanyard, or equivalent) is selected based on the patient's needs.
3. The prosthetist modifies the prosthetic socket to incorporate the chosen locking mechanism.
4. Detailed fitting ensures that the modified socket and the new suspension mechanism function correctly and comfortably.
5. The patient is instructed on how to properly use and maintain the new locking mechanism.

Duration

The fitting and modification procedure typically takes around 1 to 2 hours, depending on the complexity of the case.

Setting

The procedure is usually performed in a prosthetics clinic or an outpatient setting equipped with the necessary tools and materials.

Personnel

• Certified prosthetist
• Prosthetic technician (if required)
• Clinical staff for initial assessment and follow-up

Risks and Complications

• Minor skin irritation or pressure sores at the site of the suspension mechanism
• Initial discomfort or difficulty adjusting to the new locking mechanism
• Mechanical failure or wear and tear of the locking system
• Infection if proper hygiene isn't maintained

Benefits

• Improved stability and secure fit of the prosthetic limb
• Enhanced mobility and comfort for the patient
• Reduced risk of the prosthesis slipping or detaching
• Better weight distribution, lowering the risk of skin complications

Recovery

• Patients may need a short period to adapt to the new suspension mechanism
• Care instructions include daily cleaning of the suspension system and regular checks for wear and tear
• Follow-up appointments to ensure proper fit and function, and to make adjustments as needed

Alternatives

• Traditional suction systems
• Pin lock systems
• Belts or straps for additional security Each alternative has its pros and cons related to ease of use, comfort, and stability, which should be discussed with a prosthetist.

Patient Experience

• During the procedure, patients generally experience minimal discomfort.
• After the procedure, there may be an initial adjustment period as they get used to the new locking mechanism.
• Pain management is typically not necessary, but over-the-counter pain relief can be used if any minor discomfort arises.
• Comfort measures include ensuring a proper fit to avoid pressure points or irritation.