Name of the Procedure:

• Common Names: Exoskeletal knee-shin system fitting, Artificial knee brace fitting
• Medical Term: Addition, exoskeletal knee-shin system, single axis, manual lock (HCPCS Code: L5710)

Summary

The procedure involves fitting an exoskeletal knee-shin system that uses a single-axis manual lock mechanism. This orthopedic device assists patients with immobilized or weakened knees, offering stability and support during movement.

Purpose

• Medical Conditions Addressed: Categories of lower extremity disability, post-trauma or post-surgical recuperation.
• Goals: Provide enhanced stability for the knee, improve mobility, and prevent knee buckling or unnecessary bending.

Indications

• Difficulty or inability to control knee movements.
• Conditions like post-operative support, knee injury recovery, or paralysis that impacts knee function.
• Patients requiring stability and support for standing and walking.

Preparation

• Pre-Procedure Instructions: No specific fasting required. Wear comfortable clothing for easy access to the limb.
• Diagnostic Tests/Assessments: Physical assessment of the lower limb by a healthcare provider. Imaging studies (X-rays, MRI) if necessary to evaluate the knee structure.

Procedure Description

1. Initial Evaluation: Patient's lower limb is measured and evaluated to determine the correct size and type of the knee-shin system.
2. Device Selection: Based on the assessment, a specific exoskeletal system with a single-axis manual lock is chosen.
3. Fitting: The device is fitted to the patient’s leg, adjustments are made for comfort and proper alignment.
4. Instruction: The patient is educated on how to operate the manual lock and safely use the device.

• Tools/Equipment: Measuring tape, orthopedic toolkit for adjustments, exoskeletal knee-shin system.
• Anesthesia/Sedation: Not typically required.

Duration

The fitting procedure generally takes about 1 to 2 hours, depending on the complexity of the adjustment needed.

Setting

The procedure is performed in an orthopedic office, an outpatient clinic, or a rehabilitation center.

Personnel

• Orthopedic specialist or prosthetist
• Nurse or medical assistant

Risks and Complications

• Common Risks: Minor skin irritation, initial discomfort, and adjustment period for proper use.
• Rare Complications: Pressure sores, alignment issues, or mechanical failure of the device.

Benefits

• Stability: Improved knee stability leading to better mobility and independence.
• Pain Relief: Reduced pain associated with knee instability.
• Confidence: Increased confidence in movement and daily activities.
• Realization: Benefits are typically realized immediately after proper fitting.

Recovery

• Post-Procedure Care: Monitoring for signs of skin irritation or discomfort. Regular adjustments as needed.
• Recovery Time: Immediate functional improvement, with full adaptation typically within a few weeks.
• Restrictions/Follow-Up: Limited high-impact activities initially. Scheduled follow-ups for device tightening/adjustment.

Alternatives

• Other Options: Physical therapy, custom-molded knee orthoses, surgical interventions (if applicable).
• Pros/Cons:
  • Physical therapy: Lower cost, non-invasive but may not provide sufficient support.
  • Custom Orthoses: Personalized fit but can be costly and require long evaluation periods.
  • Surgery: Potential for more permanent solution but comes with higher risks and longer recovery times.

Patient Experience

• During Procedure: Minimal discomfort, with most activities involving standing and walking.
• Post-Procedure: Some initial discomfort as the patient becomes accustomed to the device. Regular use of pain management strategies (over-the-counter pain relievers, ice application) may be recommended. Patients usually find wearing the device increasingly comfortable as they adjust.