Name of the Procedure:

Replacement, Socket, Above Knee/Knee Disarticulation, including Attachment Plate, Molded to Patient Model (L5701)

Summary

This procedure involves creating and fitting a new prosthetic socket for patients who have undergone an above-knee amputation or knee disarticulation. The socket is uniquely molded to the patient's residual limb to ensure a proper fit and includes an attachment plate for connecting the prosthetic limb.

Purpose

This procedure addresses the need for a well-fitting prosthetic socket, which is crucial for comfort, mobility, and functionality in patients with above-knee amputations or knee disarticulations. The goal is to improve the patient’s quality of life by enhancing their ability to walk and perform daily activities.

Indications

• Patients with an above-knee amputation or knee disarticulation.
• Individuals experiencing discomfort, pain, or instability with their current socket.
• Patients requiring a new socket due to changes in limb shape or size.
• Significant wear and tear on an existing prosthetic socket.

Preparation

• Patients may need to undergo a physical evaluation and imaging studies (e.g., X-rays, MRIs) to assess the residual limb.
• It is important to maintain good hygiene of the residual limb.
• No specific fasting or medication adjustments are typically required unless otherwise instructed by the healthcare provider.

Procedure Description

1. Assessment: The residual limb is closely examined to determine the shape and size.
2. Molding: A mold of the residual limb is created, often using plaster or 3D scanning technology.
3. Fabrication: The socket is fabricated using durable materials (e.g., carbon fiber, thermoplastics) and is molded to match the patient's model.
4. Fitting: The new socket is fitted to the patient, ensuring it aligns well with the residual limb and attachment plate.
5. Adjustments: Any necessary adjustments are made for comfort and functionality.
6. Attachment: The prosthetic limb is connected to the new socket via the attachment plate.

Duration

The entire process, from assessment to final fitting, can take several hours to a few days depending on the complexity and need for adjustments.

Setting

• Prosthetics clinic
• Outpatient facility specialized in orthotics and prosthetics

Personnel

• Certified Prosthetist (CP)
• Prosthetic technicians
• Orthopedic specialists, if needed

Risks and Complications

• Skin irritation or sores at the socket interface
• Improper fit leading to discomfort or instability
• Potential need for additional adjustments or repairs
• Allergic reactions to materials (rare)

Benefits

• Enhanced comfort and mobility
• Improved walking and daily activity performance
• Better alignment and load distribution
• Immediate improvement upon proper fitting

Recovery

• Frequent follow-up visits for adjustments
• Regular monitoring for skin health and fit
• Typically, patients can start using the new socket within days.
• Avoid heavy physical activity until confirmed by the prosthetist.

Alternatives

• Liners or padding adjustments in the existing socket
• Customizing the existing prosthetic components
• Use of temporary or interim prosthetic solutions
• Each alternative has its own set of pros and cons, such as varying levels of comfort, cost, and duration of use.

Patient Experience

• Mild to moderate discomfort during the initial fitting which should subside as adjustments are made.
• Patients may need to gradually increase usage time of the new socket to get accustomed.
• Pain management strategies include the use of over-the-counter pain relievers and following proper limb care instructions.
• Support from a physical therapist may be beneficial during the adaptation period.