Procedure Information for HCPCS Code L5676

Name of the Procedure:

Additions to lower extremity, below knee, knee joints, single axis, pair
Commonly referred to as: Single Axis Knee Joints Addition

Summary

This procedure involves the fitting of single-axis knee joints as additions to lower extremity prosthetics below the knee. These joints facilitate controlled bending and straightening of the knee, aiding in fluid motion and improved walking ability for the user.

Purpose

Single-axis knee joints addition is meant to enhance mobility for individuals with lower leg prosthetics. It addresses the challenge of stabilizing the knee during walking and other activities, aiming to improve the user’s gait and overall function.

Indications

• Symptoms/Conditions: Loss of knee stability, difficulty walking, poor gait mechanics.
• Criteria: Patients with lower extremity amputations who are suitable candidates for prosthetic enhancements to improve functionality and mobility.

Preparation

• Pre-procedure Instructions: No specific fasting or medication adjustments required.
• Diagnostic Tests: Prosthetic fitting assessments, gait analysis, and possibly X-rays or other imaging to ensure proper fit and alignment.

Procedure Description

1. Assessment: A comprehensive gait analysis and residual limb examination.
2. Prosthetic Measurement: Accurate measurements of the residual limb.
3. Knee Joint Fitting: The single-axis knee joints are securely affixed to the existing below-knee prosthesis.
4. Adjustment: The knee joints are adjusted to ensure optimal alignment and functionality.
5. Testing and Training: The patient tests the prosthesis, often with physical therapy to ensure correct usage.

• Tools/Equipment: Prosthetic knee joints, alignment jigs, torque wrenches.
• Anesthesia: Generally, local anesthesia is not needed. Rare cases might require mild sedation, depending on patient comfort and anxiety levels.

Duration

The fitting and adjustment process typically takes 1-2 hours.

Setting

Performed at prosthetic clinics or specialized outpatient facilities.

Personnel

• Prosthetist
• Physical therapist
• Sometimes an orthopedic specialist

Risks and Complications

• Common Risks: Skin irritation, pressure sores, temporary discomfort during the adjustment period.
• Rare Risks: Misalignment causing gait issues, hardware failure, need for refitting or adjustments.
• Management: Regular follow-ups, adjustments, physical therapy, and patient education.

Benefits

• Improved Stability: Enhanced knee control leads to a more natural gait.
• Increased Mobility: Reduced effort in walking, allowing for longer distances and varied terrains.
• Quality of Life: Enhanced independence and physical activity.

Recovery

• Post-Procedure Care: Regular cleaning and maintenance of the prosthesis, skin care to prevent irritation.
• Expected Recovery Time: Immediate functional improvement, acclimatization period up to a few weeks.
• Restrictions: Limited high-impact activities initially; follow-up visits for adjustments.

Alternatives

• Other Options: Polycentric knee joints, hydraulic or microprocessor-controlled knees.
• Pros and Cons: Alternatives might offer superior functionality but at a higher cost or complexity. Single-axis joints are simpler and more durable.

Patient Experience

• During Procedure: Minimal discomfort, primarily from fitting and minor adjustments.
• After Procedure: Initial adaptation period may involve slight discomfort, managed by physical therapy and minor adjustments. Pain is generally minimal and can be addressed with over-the-counter pain relievers if necessary.