Name of the Procedure:

• Common Name(s): Artificial Hip Extension Assist
• Technical/Medical Term: Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist (L5855)

Summary

This procedure involves the addition of a mechanical hip extension assist to an existing endoskeletal prosthesis for patients who have undergone hip disarticulation. The mechanical assist helps in extending the hip, providing improved mobility and stability.

Purpose

• Medical Conditions/Problems Addressed: Provides improved mobility for individuals who have had a hip disarticulation, generally due to severe trauma, tumors, or congenital conditions.
• Goals/Expected Outcomes: Enhance the patient’s ability to walk and perform daily activities with better ease and reduced energy expenditure.

Indications

• Symptoms/Conditions: Loss of hip function following hip disarticulation.
• Patient Criteria: Individuals requiring a prosthetic solution for improved hip function and mobility post-hip disarticulation.

Preparation

• Pre-Procedure Instructions: Generally, no specific preparations such as fasting or medication adjustments are needed. Patients may have to attend a fitting session for the device.
• Diagnostic Tests/Assessments: Evaluation by a prosthetist and potentially imaging studies to ensure proper device fitting.

Procedure Description

• Detailed Steps:
  1. The prosthetist assesses the patient’s residual limb and overall health.
  2. Measurements and molds of the residual limb are taken for optimal fit.
  3. The mechanical hip extension assist is tailored and attached to the existing endoskeletal prosthetic system.
  4. The device is then fitted to the patient, ensuring comfort and proper alignment.
  5. Initial testing and adjustments are made to ensure functionality.
• Tools/Equipment: Endoskeletal prosthesis, mechanical hip extension assist device, fitting tools.
• Anesthesia/Sedation: Not applicable.

Duration

• Time: The fitting and adjustment procedure typically takes a few hours.

Setting

• Location: This procedure is usually performed in an outpatient clinic or a specialized prosthetics and orthotics center.

Personnel

• Healthcare Professionals: Prosthetist, possibly a physician or rehabilitation specialist, and support staff.

Risks and Complications

• Common Risks: Minor skin irritation or discomfort.
• Rare Risks: Improper fit leading to gait issues, pressure sores, or mechanical failure of the device.
• Management: Regular follow-up appointments to adjust and fine-tune the device as needed.

Benefits

• Expected Benefits: Improved walking ability, greater stability, reduced energy expenditure during movement.
• Realization Time: Benefits are often realized soon after proper fitting and initial use, with further improvements as the patient adapts.

Recovery

• Post-Procedure Care: Regular follow-up for adjustments; skin care to monitor for irritation.
• Recovery Time: Immediately usable post-fitting; full adaptation can take a few weeks.
• Restrictions/Follow-Up: Limited operational restrictions, routine follow-up for adjustments.

Alternatives

• Other Options: Other types of prosthetics without mechanical assist, or mobility aids such as wheelchairs.
• Pros and Cons: Alternates like simpler prosthetics may be less costly but provide reduced functionality. Wheelchairs offer ease but limit certain mobility aspects.

Patient Experience

• During Procedure: Generally painless fitting session.
• After Procedure: Initial period of adjustment to new movement mechanics; some physical therapy might be recommended. Pain management typically involves over-the-counter pain relievers if needed, and ongoing support from the prosthetist to ensure comfort.