Name of the Procedure:

Addition, endoskeletal system, above knee or hip disarticulation, alignable system (HCPCS Code: L5920)

Summary

This procedure involves the addition of an alignable endoskeletal system for patients who have undergone a knee or hip disarticulation. This system enhances the alignment and fit of the existing prosthetic limb.

Purpose

It addresses misalignment issues in patients with an above-knee amputation or hip disarticulation who use prosthetic limbs. The expected goal is to improve the comfort, functionality, and mobility of the prosthetic limb, leading to an enhanced quality of life.

Indications

• Misalignment issues with the current prosthetic limb
• Poor fit leading to discomfort or limited mobility
• Recurrent skin irritation or sores due to prosthetic misalignment
• Patients who have undergone an above-knee amputation or hip disarticulation

Preparation

• Initial consultation to assess the current prosthetic alignment
• Diagnostic imaging (such as X-rays) to evaluate the alignment and fit
• Adjustments in medication might not be necessary but consult with your healthcare provider
• No specific fasting or dietary restrictions needed

Procedure Description

1. The prosthetist evaluates the existing prosthetic limb alignment.
2. Necessary adjustments are planned based on diagnostic imaging results.
3. Using tools like wrenches and alignment fixtures, the endoskeletal system is adjusted to better fit the patient's residual limb.
4. The alignable system components are installed or modified.
5. The patient tests the new alignment, and further minor adjustments are made if needed.

Duration

This procedure typically takes about 1 to 2 hours.

Setting

The procedure is performed in a specialized prosthetics and orthotics clinic or an outpatient clinic.

Personnel

• Certified Prosthetist
• Prosthetic Technician
• Clinic Nurse (if needed for assistance)

Risks and Complications

• Minor discomfort during the adjustment process
• Temporary skin irritation as the limb adjusts to the new alignment
• Rare risk of infection if the skin around the residual limb is breached

Benefits

• Improved comfort and fit of the prosthetic limb
• Enhanced mobility and function
• Reduction in skin irritation and associated complications

Recovery

• Immediate feedback and adjustment period during and after the procedure
• Patients may experience slight discomfort as they get accustomed to the new fit, typically resolving in a few days
• Regular follow-up appointments are recommended to monitor progress and make further adjustments if needed

Alternatives

• Traditional non-adjustable prosthetic limb systems
• Custom-made prosthetic limbs specifically fabricated to the individual's residual limb
• Pros: Custom systems offer a tailored fit from the start
• Cons: Lack the flexibility for future adjustments that alignable systems offer

Patient Experience

• During the procedure: Mild discomfort or pressure as adjustments are made
• After the procedure: Initial period of adaptation; minor discomfort is expected
• Pain management: Over-the-counter pain relievers can be used if necessary
• Comfort measures: Follow-up visits to ensure optimal fit and address any discomfort

This information aims to provide a clear, comprehensive understanding of the procedure and its implications for patients requiring an alignable endoskeletal system above-knee or hip disarticulation.