Name of the Procedure:

Addition, Endoskeletal Knee-Shin System, Single Axis, Fluid Swing and Stance Phase Control (HCPCS L5828).

Summary

The procedure involves the fitting and customization of a prosthetic knee-shin system that uses fluid mechanics to control the swing and stance phases for individuals requiring a lower limb prosthesis. This advanced system helps enhance mobility and stability for the user.

Purpose

The endoskeletal knee-shin system addresses the loss of a limb, typically due to amputation. The primary goals are to improve the user's ability to walk smoothly, increase stability, and reduce effort during movement.

Indications

• Limb loss due to trauma, disease, or congenital conditions.
• Patients seeking improved mobility and stability with a prosthetic limb.
• Candidates must be capable of using fluid-controlled systems effectively, often evaluated by a prosthetist.

Preparation

• Pre-procedure consultations with a prosthetist to assess suitability.
• Physical assessments and gait analysis.
• No specific fasting or significant pre-procedure preparation required.

Procedure Description

1. Initial Assessment: Detailed evaluation by a prosthetist including measurements and gait analysis.
2. Casting or Scanning: Creation of a precise mold or 3D scan of the residual limb.
3. Fitting: Customization and fitting of the endoskeletal knee-shin system.
4. Adjustment: Fine-tuning the prosthetic to ensure proper fit and function, paying particular attention to fluid mechanics for swing and stance phases.
5. Training: Providing the patient with instructions and practice sessions to adapt to the new prosthetic.

Duration

Initial fitting and adjustment can take several hours, spread over multiple sessions depending on the complexity and patient’s adaptability.

Setting

Typically performed in specialized prosthetic or orthotic clinics.

Personnel

• Certified Prosthetist/Orthotist (CPO)
• Prosthetic technicians
• Physical therapists for follow-up gait training

Risks and Complications

• Skin irritation or pressure sores at the site of contact.
• Mechanical failure or malfunction of the prosthetic components.
• Adjustments may be required for optimal fit and performance.

Benefits

• Enhanced mobility with smoother, more natural walking.
• Improved comfort and stability during movement.
• Potential for greater independence in daily activities.

Recovery

• Immediate use is possible post fitting, but adaptation varies by individual.
• Ongoing adjustments and follow-ups are common.
• Physical therapy may be recommended to optimize gait and use.

Alternatives

• Mechanical knee systems with less advanced control.
• Microprocessor-controlled knee units for more advanced needs.
• Each alternative varies in cost, complexity, and user adaptability.

Patient Experience

Patients may experience an adjustment period with some initial discomfort as they get used to the new system. Regular consultations and adjustments, along with physical therapy, help in managing any discomfort and enhancing comfort and efficiency. Pain management strategies are rarely necessary due to the non-invasive nature of the fitting.

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