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Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)

HCPCS code

Name of the Procedure:

Addition, Exoskeletal System, Below Knee, Ultra-Light Material (Titanium, Carbon Fiber or Equal)
Common name(s): Below Knee Prosthesis Enhancement
Technical/medical term: Exoskeletal Prosthetic Addition using Ultra-Light Materials

Summary

This procedure involves adding an ultra-light material, such as titanium or carbon fiber, to a below-knee prosthetic system. This enhances the prosthesis, making it lighter and more comfortable for the user, thereby improving mobility and overall quality of life.

Purpose

The addition of ultra-light materials to a below-knee prosthesis is primarily done to:

  • Reduce the weight of the prosthesis
  • Improve comfort for the user
  • Enhance mobility and ease of use
  • Reduce fatigue associated with using heavier prosthetic devices

Indications

  • Patients with a below-knee amputation requiring a prosthetic enhancement
  • Individuals experiencing discomfort or strain from a heavier prosthetic limb
  • Patients seeking improved mobility and performance in their prosthetic leg
  • Cases where the existing prosthetic system fails to meet the user’s daily activity requirements

Preparation

  • Detailed assessment of the existing prosthetic fit and functionality
  • Physical examination and gait analysis
  • Patient consultation discussing the benefits and potential risks
  • No specific fasting or medication adjustments are generally required, but follow your healthcare provider’s instructions

Procedure Description

  1. Initial Assessment: The healthcare provider will evaluate the current prosthetic limb.
  2. Customization: Measurements and molds of the residual limb are taken for precise fitting.
  3. Material Selection: Ultra-light materials like titanium or carbon fiber are chosen based on patient needs, activity level, and preference.
  4. Adjustment and Fitting: The ultra-light material is integrated into the exoskeletal system of the prosthesis. This involves cutting, shaping, and fitting the material to ensure optimal comfort and functionality.
  5. Finishing: Final adjustments are made, and the prosthetic limb is finished with a cosmetic cover if desired.
  6. Fitting Session: The patient tries on the enhanced prosthesis and adjustments are made as needed for comfort and functionality.

Duration

The procedure typically takes a few hours to complete, spread over multiple sessions, including initial assessment, fitting, and final adjustments.

Setting

The procedure is generally performed in an outpatient clinic specializing in prosthetics and orthotics.

Personnel

  • Prosthetist (primary provider)
  • Orthopedic technician (assistant)
  • Occasionally, a physical therapist to assist with gait training and assessment

Risks and Complications

  • Skin irritation or sores from initial fitting
  • Mechanical failure or material fatigue over time
  • Potential allergic reaction to new materials
  • Misalignment causing discomfort or gait issues

Benefits

  • Significant reduction in prosthetic limb weight
  • Increased comfort and decreased strain on the residual limb
  • Enhanced mobility and balance
  • Potential for greater control and natural movement of the prosthetic limb

Recovery

  • Immediate post-fitting follow-up for adjustments
  • Gradual familiarization with the enhanced prosthetic limb
  • Physical therapy sessions may be required to optimize gait and mobility
  • Full recovery and adaptation typically occur within a few weeks to a few months

Alternatives

  • Standard weight prosthetic limbs
  • Enhanced prosthesis using different materials (non-titanium/carbon fiber)
  • Advanced prosthetic systems with microprocessors and sensors
  • Each alternative comes with its own set of benefits and drawbacks relating to cost, weight, and functionality

Patient Experience

Patients might feel an immediate improvement in comfort due to the lighter weight. Initial fittings might involve some discomfort or adjustment periods. Regular follow-ups ensure proper fit and function. Pain management usually involves over-the-counter pain relievers for minor soreness, and any significant discomfort should be reported to the healthcare provider promptly. Comfort measures, like padding and liners, are used to ensure a snug and irritation-free fit.

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