Name of the Procedure:

Addition, Endoskeletal Knee-Shin System, Single Axis, Friction Swing and Stance Phase Control (Safety Knee)

Summary

This procedure involves fitting a prosthetic device known as a single-axis endoskeletal knee-shin system. This type of prosthesis features frictional swing and stance phase control, making it a "safety knee" designed to help amputees walk more securely and comfortably.

Purpose

The primary goal of this procedure is to improve mobility and overall quality of life for individuals who have experienced above-knee amputations. The system provides stability during walking and helps prevent falls by controlling knee movement.

Indications

• Above-knee amputations due to trauma, medical conditions (e.g., peripheral arterial disease), or congenital defects.
• Patients struggling with stability and control using other types of prosthetic knees.
• Individuals without pre-existing cognitive impairments or severe medical conditions that could affect the use of the prosthesis.

Preparation

• Comprehensive evaluation by a prosthetist and an orthopedic specialist.
• Measurements and casting of the residual limb.
• Assessment of overall health, including cardiovascular and neurological evaluations.
• No specific fasting required; medication adjustments as advised by the physician.

Procedure Description

1. Initial Consultation: An initial evaluation to assess the patient's needs and design a custom-fitting knee-shin system.
2. Casting and Measurement: Taking an exact mold of the residual limb to create a custom socket.
3. Prosthesis Fitting: Attaching the single-axis endoskeletal knee-shin system to the custom socket.
4. Alignment and Adjustment: Fine-tuning the prosthesis to ensure comfort, alignment, and proper friction settings for swing and stance phases.
5. Training and Rehabilitation: Guided physical therapy sessions to help the patient adapt to the prosthesis.

Tools and Equipment:

• Casting materials
• Measurement tools
• Single-axis endoskeletal knee-shin prosthetic components
• Adjustment tools

Anesthesia: Generally, no anesthesia is required for fittings and adjustments.

Duration

The fitting and adjustment process typically takes several hours over multiple visits. Initial consultation and measurements may take about 1-2 hours, while follow-up visits for adjustments and gait training may require additional time.

Setting

The procedure is usually performed in a specialized prosthetics clinic or outpatient rehabilitation center.

Personnel

• Prosthetist
• Orthopedic specialist
• Physical therapist
• Medical assistant

Risks and Complications

• Skin irritation or sores at the site of the prosthetic socket
• Misalignment requiring further adjustments
• Mechanical failure or wear and tear of prosthetic components
• Difficulty adapting to the new prosthesis, leading to fatigue or discomfort

Benefits

• Improved mobility and stability, reducing the risk of falls.
• Enhanced comfort and gait.
• Increased independence in daily activities. Benefits might be noticed immediately but may take a few weeks of adaptation and physical therapy to be fully realized.

Recovery

• Regular follow-up appointments for adjustments and assessments.
• Instructions on daily maintenance and care of the prosthesis.
• Gradual increase in activity levels as comfort and adaptation improve.
• Expected adaptation time can range from a few weeks to a few months.

Alternatives

• Mechanical or computerized prosthetic knees with different control mechanisms.
• Knee-shin systems with multi-axis or polycentric designs.
• Wheelchairs or other mobility aids for those who are not candidates for prosthetics. Each alternative has its pros and cons regarding stability, ease of use, and suitability based on the patient's health and lifestyle.

Patient Experience

• Initial discomfort or difficulty in adapting to the new prosthesis.
• Physical therapy to learn how to walk properly with the prosthesis.
• Possible need for pain management strategies or medications.
• Gradual improvement in mobility, stability, and confidence over time.