Name of the Procedure:

Common Name(s): Lower extremity prosthesis
Technical/Medical Term: Combination single axis ankle and flexible keel foot prosthesis (HCPCS Code L5975)

Summary

This procedure involves fitting a patient with a combination single axis ankle and flexible keel foot prosthesis. This type of prosthetic device mimics the natural movement of the ankle and foot, allowing for a more natural gait and improved mobility for individuals with lower extremity amputations.

Purpose

Medical Conditions/Problems:

• Lower limb amputation
• Arthritis leading to functional impairment
• Traumatic injury resulting in amputation

Goals/Expected Outcomes:

• Restore mobility and functional independence
• Improve gait and balance
• Enhance quality of life by enabling day-to-day activities with more ease

Indications

Symptoms/Conditions:

• Loss of lower limb due to traumatic injury
• Complications from diabetes resulting in amputation
• Vascular diseases leading to amputation

Patient Criteria:

• Candidates who have undergone lower limb amputation
• Patients with stable residual limb and healthy skin condition
• Individuals with potential for rehabilitation and motivation to use a prosthesis

Preparation

Pre-Procedure Instructions:

• Ensure the residual limb is healed from surgery and free of infection
• Patients may need to refrain from eating or drinking if anesthesia is required
• Specific medications might need to be adjusted or paused

Diagnostic Tests/Assessments:

• X-rays and imaging studies to assess bone and joint status
• Assessment of muscle strength and range of motion in the remaining limb
• Psychological evaluation for readiness and coping

Procedure Description

1. Evaluation: The prosthetist evaluates the residual limb and takes measurements.
2. Fitting: A temporary prosthesis may be made first for initial fitting.
3. Fabrication: The definitive prosthesis is fabricated to custom-fit the patient's residual limb.
4. Alignment: The single axis ankle and flexible keel foot are aligned for optimal gait.
5. Training: The patient undergoes physical therapy to learn how to use the prosthesis effectively.

Tools/Equipment:

• Custom molds and casting materials
• Prosthetic components including the single axis ankle and flexible keel foot

Anesthesia/Sedation: Typically, none required for the fitting process, but some procedures might need local anesthesia.

Duration

The entire fitting process may take several sessions over a few weeks.

Setting

Prosthetist’s clinic or a specialized prosthetics and orthotics facility.

Personnel

• Prosthetist
• Physical therapist
• Occasionally a rehabilitation physician

Risks and Complications

Common Risks:

• Skin irritation or breakdown at the residual limb
• Discomfort or improper fitting

Rare Risks:

• Infection (if skin breakdown occurs)

Complications Management:

• Frequent follow-ups for adjustments and skin inspections

Benefits

Expected Benefits:

• Enhanced mobility and independence
• Reduced energy expenditure compared to older prosthesis models
• More natural walking gait

Realization Timeframe:

• Immediate improvements post initial fitting
• Continued improvements over months with physical therapy

Recovery

Post-Procedure Care:

• Regular monitoring of the residual limb for skin breakdown
• Proper hygiene routines

Expected Recovery Time:

• Varies individually; walking proficiency may be achieved within months

Restrictions/Follow-Ups:

• Regular follow-ups for adjustments and monitoring
• Gradual increase in activity levels

Alternatives

Other Treatment Options:

• Basic foot-ankle prosthesis without flexible keel
• Powered prosthetic foot and ankle systems

Pros and Cons:

• Basic prosthesis: Less costly, simpler but less natural movement
• Powered systems: More natural movement but more expensive and heavier

Patient Experience

What to Expect:

• Initial discomfort as the body adjusts to the new prosthesis
• Gradual reduction in pain with physical therapy

Pain Management:

• Analgesics if needed initially
• Emphasis on gradual acclimatization and physical therapy for muscle adaptation and comfort.

This markdown text offers a comprehensive, easy-to-understand guide on the lower extremity prosthesis with a combination single axis ankle and flexible keel foot.