Name of the Procedure:

Addition, Endoskeletal System, Above Knee or Hip Disarticulation, Knee Extension Assist (L5850)

• Common Name(s): Knee Extension Assist Prosthesis
• Technical/Medical Terms: Endoskeletal knee prosthesis with extension assist mechanism

Summary

An endoskeletal knee extension assist is a prosthetic procedure for individuals who have undergone an above-knee amputation or hip disarticulation. It involves fitting a prosthetic limb equipped with a knee extension mechanism aimed at improving mobility and quality of life.

Purpose

The procedure addresses mobility issues resulting from the loss of a leg above the knee or hip disarticulation. The main goals are to:

• Enhance knee control and stability.
• Improve the patient's ability to walk and perform daily activities.
• Increase overall quality of life and independence.

Indications

• Above-knee amputation
• Hip disarticulation
• Inadequate mobility or performance with current prosthesis
• Desire for improved functionality and stability

Preparation

• Physical assessment by a prosthetist and physician.
• Diagnostic tests such as X-rays or MRI (if required) to evaluate bone and soft tissue health.
• Instructions on any necessary medication adjustments or fasting requirements.
• Measurements and casting of the residual limb for a custom-fit prosthesis.

Procedure Description

1. Initial Assessment: Thorough physical evaluation and patient history review.
2. Fitment: Custom-fabrication of the prosthesis based on the patient's measurements.
3. Component Assembly: Construct the endoskeletal system incorporating the knee extension assist mechanism.
4. Fitting Session: Fitting the patient with the prosthetic limb and making necessary adjustments.
5. Training: Practicing with the prosthesis under supervision to ensure proper use and functionality.
   • Tools and Equipment: Prosthetic components, alignment tools, measurement devices.
   • Anesthesia: Not typically required.

Duration

The entire process, including custom fabrication, fitting, and training, may take several weeks. Individual sessions are generally 1-2 hours each.

Setting

• Prosthetics clinic or outpatient facility
• Physical therapy or rehabilitation center

Personnel

• Prosthetist
• Rehabilitation specialist/physical therapist
• Physician (for initial assessment and follow-up care)

Risks and Complications

• Skin irritation or pressure sores at the site of attachment
• Misalignment or improper fit
• Mechanical failure or wear and tear of the prosthetic components
• Potential for falls or instability during the initial use period

Benefits

• Enhanced stability and control while walking
• Improved mobility and ability to perform daily activities
• Decreased energy expenditure compared to other prosthetic options
• Increased comfort and better cosmetic appearance

Recovery

• Post-procedure follow-up appointments to monitor progress and make adjustments.
• Daily wear and progressive training to adapt to the new prosthesis.
• Expected recovery and adaptation time: several weeks to a few months.
• Follow any specific restrictions provided by the healthcare team.

Alternatives

• Manual prostheses without knee extension assist
• Microprocessor-controlled knee units
• Wheelchair for mobility (if prosthetic solution is not viable)
• Each alternative has its own set of pros and cons, such as differences in cost, functionality, and ease of use.

Patient Experience

• During the Procedure: Minimal discomfort during fitting sessions.
• Post-Procedure: Initial discomfort or learning curve with new prosthesis. Pain management strategies and physical therapy will aid in adjustment and comfort.