Name of the Procedure:

Addition, Endoskeletal System, Above Knee, Knee Disarticulation or Hip Disarticulation, Manual Lock (L5925)

Summary

This is a surgical procedure to fit a manual lock mechanism into an endoskeletal prosthesis for individuals who have undergone an above-knee, knee disarticulation, or hip disarticulation amputation. The manual lock mechanism ensures the stability of the prosthesis, providing the patient with improved safety and mobility.

Purpose

The procedure aims to address the reduced mobility and stability issues faced by patients with above-knee, knee disarticulation, or hip disarticulation amputations. The primary goals are to improve the patient's ability to stand, walk, and perform daily activities with enhanced safety and confidence.

Indications

• Patients who have undergone an above-knee, knee disarticulation, or hip disarticulation amputation.
• Individuals experiencing instability or reduced mobility with their current prosthesis.
• Those requiring a more secure locking mechanism for their prosthetic limb to ensure safety during movement.

Preparation

• Pre-operative assessment to evaluate overall health and suitability for the procedure.
• Discuss potential risks and benefits with the healthcare provider.
• Adjustments to medications as advised by the physician.
• No specific fasting required unless general anesthesia is planned.

Procedure Description

1. The patient’s residual limb is examined and measured to custom-fit the endoskeletal prosthesis.
2. The manual lock component is selected, ensuring compatibility with the individual's prosthetic needs and limb specifications.
3. If necessary, minor surgical adjustments to the residual limb are performed to ensure a secure fit.
4. The manual lock mechanism is integrated into the endoskeletal system of the prosthesis.
5. Proper alignment and adjustment of the prosthesis with the manual lock are made for optimal function.

Duration

The installation of the manual lock into the prosthetic system typically takes between 1 to 2 hours.

Setting

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

Personnel

• Prosthetist (specializes in prosthetic limbs)
• Rehabilitation specialist (may assist in fitting and alignment)
• Nurse (provides pre- and post-procedure care)

Risks and Complications

• Infection at the site of attachment or adjustment
• Improper alignment leading to discomfort or gait issues
• Mechanical failure of the manual lock
• Skin irritation or pressure sores from the prosthesis interface

Benefits

• Enhanced stability and safety while standing and walking.
• Increased confidence in daily activities without the fear of the prosthesis giving way.
• Improved overall quality of life and mobility.

Recovery

• Initial discomfort as the patient adjusts to the new manual lock mechanism.
• Regular follow-up appointments to ensure proper fit and function.
• Patients are advised to avoid rigorous activities initially and gradually increase their activity level.
• Skin care to prevent irritation or sores from the prosthetic interface.

Alternatives

• Pneumatic or hydraulic prosthetic systems, which may offer more natural movement but can be more expensive and complex.
• Prosthetics with microprocessor-controlled knee joints offering dynamic stability adjustments.
• Regular above-knee prosthetics without manual locks but with other stability features.

Patient Experience

During the fitting process, patients might feel a sensation of pressure or tightness as the prosthesis is adjusted. After the procedure, there might be some initial discomfort which can be managed with over-the-counter pain medication. Adaptation to the manual lock mechanism generally occurs over a few weeks with proper rehabilitation and physical therapy supporting the transition.