Name of the Procedure:

Addition to Lower Extremity, Below Knee, Waist Belt, Padded and Lined (L5690)

Common Name: Below-Knee Prosthetic Suspension System with Waist Belt
Technical Term: Prosthetic Suspension System Addition – Waist Belt (HCPCS Code L5690)

Summary

This procedure involves adding a padded and lined waist belt to a below-knee prosthetic device. The waist belt enhances the stability and comfort of the prosthetic limb, ensuring better suspension and fit for the wearer.

Purpose

This addition is designed to improve the stability and comfort of a below-knee prosthesis. It addresses issues such as prosthetic slippage, instability, and discomfort, providing a more secure attachment of the prosthetic limb to the body, which can enhance mobility and confidence in daily activities.

Indications

• Patients with below-knee amputations experiencing prosthetic slippage or instability.
• Individuals with sensitive skin requiring additional padding and lining for comfort.
• Cases where additional support and suspension are needed for the prosthetic limb.

Preparation

• The patient may need an initial assessment by a prosthetist to evaluate the fit and comfort of their current prosthetic limb.
• No special pre-procedure preparations such as fasting or medication adjustments are typically required.

Procedure Description

1. Assessment:
   • The prosthetist assesses the current prosthetic limb and identifies the need for a waist belt.
2. Customization:
   • The waist belt is padded, lined, and customized to fit the patient’s body shape and size.
3. Attachment:
   • The waist belt is securely attached to the upper part of the below-knee prosthetic device.
4. Fitting:
   • The prosthetic limb with the added waist belt is fitted onto the patient, ensuring that it provides the desired support and comfort.
5. Adjustments:
   • Necessary adjustments are made to ensure optimal fit and function.

Tools and Equipment:

• Padded and lined waist belt.
• Prosthetic fitting tools and adjustment devices.

Anesthesia:

• Not applicable, as this is a non-surgical procedure.

Duration

The entire process typically takes about 1 to 2 hours, including assessment, customization, fitting, and adjustments.

Setting

The procedure is usually performed in a prosthetics clinic or an outpatient setting specializing in orthotics and prosthetics.

Personnel

• Prosthetist: A healthcare professional specializing in the design and fitting of prosthetic limbs.
• Prosthetic Technician: May assist in adjustments and fittings.

Risks and Complications

• Common: Mild discomfort or irritation at the waist belt contact points.
• Rare: Skin abrasions or pressure sores if the waist belt is not properly fitted or adjusted.

Benefits

• Enhanced prosthetic limb stability and suspension.
• Improved comfort and reduced skin irritation.
• Increased confidence and mobility for the patient.

Recovery

• Immediate post-procedure care generally involves monitoring for any discomfort or skin irritation.
• The patient should follow instructions from the prosthetist regarding the use and care of the new waist belt.
• Regular follow-up appointments may be necessary to ensure the fit remains optimal as the patient adjusts to the new addition.

Alternatives

• Suspension Sleeves: Elastic sleeves that provide additional suspension but may not offer the same level of stability as a waist belt.
• Suction Sockets: Prosthetic sockets that use vacuum suction to hold the limb in place, though these may not be suitable for all patients.

Pros and Cons of Alternatives:

• Suspension Sleeves:
  • Pros: Less bulky, easier to use.
  • Cons: May provide less stability and comfort.
• Suction Sockets:
  • Pros: Excellent suspension, no external belts required.
  • Cons: May require more precise fitting and maintenance.

Patient Experience

• During the procedure, the patient may feel mild pressure and adjustments as the waist belt is fitted.
• After the procedure, there may be a short period of adaptation as the patient gets used to the new addition.
• Pain management is generally not necessary, but any discomfort should be reported to the prosthetist for adjustments.