Name of the Procedure:

Addition to Lower Extremity, Above Knee or Knee Disarticulation, Pelvic Band
Common names: Pelvic Band Attachment, Above Knee Prosthetic Addition
Technical/Medical term: HCPCS Code L5697

Summary

Pelvic Band Attachment is a surgical procedure where a supportive pelvic band is added to a lower extremity prosthetic device. This is typically used for individuals who have undergone an above-knee amputation or knee disarticulation to enhance prosthetic stability and comfort.

Purpose

The primary purpose of this procedure is to provide added stability, control, and comfort to patients using above-knee prosthetic devices. It helps in better weight distribution and secure attachment, allowing for improved mobility and functionality in daily activities.

Indications

• Above-knee amputations or knee disarticulation surgeries.
• Individuals experiencing discomfort or instability with their current prosthetics.
• Patients requiring additional support and stabilization in their prosthetic devices.

Preparation

• Pre-procedure consultation with the prosthetist and surgeon.
• Assessment of the current prosthetic fit and functional issues.
• No specific fasting or medication adjustments needed, though general pre-operative guidelines may apply.

Procedure Description

1. Initial Assessment and Marking: The patient’s residual limb and pelvic anatomy are carefully evaluated.
2. Customization and Fitting: Measurements are taken to customize the pelvic band for proper fit and comfort.
3. Attachment: The pelvic band is integrated into the existing prosthetic device above the knee, ensuring it aligns properly for stability and support.
4. Adjustment and Testing: Post-attachment, the fit is adjusted, and the patient is tested for comfort and mobility.

Tools/Equipment: Adjustable prosthetic tools, measurement devices, padding materials for the pelvic band.

Anesthesia/Sedation: Typically not required unless combined with another invasive procedure.

Duration

The procedure normally takes about 1 to 2 hours, inclusive of adjustments and patient testing.

Setting

Performed in an outpatient clinic or a specialized prosthetic center.

Personnel

• Prosthetist
• Orthopedic surgeon (if further surgical intervention is necessary)
• Support staff (nurses, technicians)

Risks and Complications

• Skin irritation or pressure sores at the site of the pelvic band.
• Improper fitting leading to discomfort or instability.
• Rare complications may include allergic reaction to materials used or infection if the skin integrity is compromised.

Benefits

• Enhanced stability and comfort of the prosthetic limb.
• Improved mobility and functional ability.
• Reduced risk of falls and improved quality of life.

Recovery

• Post-procedure care involves regular monitoring for any signs of irritation or pressure sores.
• The patient may experience a brief adjustment period to get used to the new component.
• Follow-up appointments for reassessment and adjustments are typically scheduled within a week or two.

Alternatives

• Use of other types of stabilizing components like soft socket interfaces.
• Reinforcement of existing prosthetic sockets.
• Physical therapy to improve residual limb strength and prosthetic control.

Pros and Cons: Pelvic bands offer considerable stability but might require an adjustment period. Other methods might not provide equivalent support but could be less invasive.

Patient Experience

Patients may initially feel discomfort as they adjust to the pelvic band but should experience improved stability and mobility soon after. Pain management includes over-the-counter pain relievers and specific comfort measures such as padding adjustments. Regular follow-ups ensure best outcomes and ongoing comfort.