Name of the Procedure

Addition to Lower Limb Prosthesis, Multiaxial Ankle with Swing Phase Active Dorsiflexion Feature (L5968) Common Names: Upgraded ankle joint prosthesis, multi-directional ankle joint with active lift.

Summary

This procedure involves adding an advanced, multi-directional ankle joint to a lower limb prosthesis. This component includes a feature that actively helps the foot lift during the swing phase of walking, making movement more natural and reducing the effort required for walking.

Purpose

Medical Conditions Addressed:

• Limb loss or amputation of the lower limb

Goals/Outcomes:

• Improve mobility and gait
• Enhance balance and stability
• Increase walking efficiency and comfort
• Reduce physical strain and energy expenditure for the user

Indications

Symptoms/Conditions:

• Patients with a lower limb prosthesis seeking improved mobility
• Individuals experiencing discomfort or instability with their current prosthetic foot

Patient Criteria:

• Persons with an amputated lower limb requiring enhanced prosthetic functionality
• Adequate physical condition to benefit from increased mobility features

Preparation

Pre-procedure Instructions:

• No specific fasting or medication adjustments are typically necessary
• Measurements and assessment of the residual limb and current prosthesis

Required Assessments:

• Gait analysis
• Evaluation by a prosthetist to ensure proper fit and functionality

Procedure Description

1. Assessment: The prosthetist evaluates the current prosthetic limb and takes precise measurements.
2. Customization: The new multiaxial ankle with active dorsiflexion feature is prepared based on individual requirements.
3. Fitting: The advanced ankle joint is attached to the existing prosthesis.
4. Adjustment: The prosthetist adjusts the alignment and settings of the prosthetic limb to ensure optimal function and comfort.
5. Training: The patient is guided through exercises to adapt to the new prosthetic component, with emphasis on balance and walking.

Tools and Equipment:

• Allen wrenches and specialized tools for adjustment
• Modular components for the prosthesis

Anesthesia:

• None required for the procedure itself; minor discomfort might be managed with local anesthetics if needed.

Duration

Typically 1 to 2 hours, including fitting and initial walking trials.

Setting

• Outpatient clinic
• Prosthetic and orthotic care facility

Personnel

• Certified prosthetist
• Physical therapist (for gait training)
• Possibly a physician overseeing care

Risks and Complications

Common Risks:

• Discomfort or irritation at the site of the prosthesis attachment
• Initial difficulty walking with the new component

Rare Risks:

• Alignment issues necessitating re-adjustment
• Mechanical failure of the new prosthetic component

Complication Management:

• Regular follow-ups for adjustment
• Immediate consultation with the prosthetist if problems arise

Benefits

• Enhanced walking efficiency and gait
• Reduced energy expenditure
• Greater comfort and stability
• Improved overall mobility

Timeline for Benefits:

• Benefits typically realized within a few weeks of use as the patient adapts.

Recovery

Post-Procedure Care:

• Follow-up sessions for adjustments and monitoring
• Gait training and physical therapy as required

Recovery Time:

• Immediate use with gradual adaptation over several weeks
• Light restrictions on high-impact activities initially

Follow-up Appointments:

• Regular check-ins with the prosthetist for the first few months

Alternatives

Other Treatment Options:

• Standard prosthetic feet without active dorsiflexion
• Mechanical, single-axis prosthetic ankles

Pros and Cons of Alternatives:

• Non-active prosthetics may be less expensive but offer reduced mobility
• Less complex prosthetics might be easier to maintain but lack advanced features

Patient Experience

During Procedure:

• Minimal discomfort during fitting

After Procedure:

• Possible initial soreness or irritation at the attachment site
• Gradual improvement in comfort and mobility

Pain Management:

• Over-the-counter pain relievers if needed
• Follow-up care for any persistent discomfort