Name of the Procedure:

Lower Extremity Prostheses, Foot, Multiaxial Ankle/Foot (HCPCS Code: L5978)

Summary

This procedure involves fitting a patient with a specialized prosthetic foot that has a multiaxial ankle joint. This advanced prosthesis allows for greater flexibility and movement, closely mimicking the natural motion of a human foot and ankle.

Purpose

The primary goal of this procedure is to restore mobility and functionality to individuals who have lost a lower limb. It aims to enhance the user's ability to perform daily activities, improve balance, and provide more natural gait mechanics.

Indications

• Amputation of the lower extremity below the knee
• Chronic pain or dysfunction in the existing prosthesis
• Need for improved mobility and functionality
• Active lifestyle requiring enhanced balance and range of motion

Preparation

• Consultation with a prosthetist to discuss needs and expectations
• Potential imaging studies (e.g., X-rays) to evaluate the remaining limb
• Adjustments in medication (if necessary) as advised by the healthcare provider
• Ensuring the residual limb is in good condition and free of infection

Procedure Description

1. Assessment: The prosthetist evaluates the residual limb and overall health of the patient.
2. Impression/Molding: A cast or digital scan of the residual limb is taken to create a custom socket.
3. Fitting: The multiaxial ankle/foot prosthesis is fitted and adjusted to ensure comfort and functionality.
4. Alignment & Adjustment: Fine-tuning the alignment of the prosthesis to optimize gait and balance.
5. Instruction: Patients are taught how to use and care for their new prosthesis.

Duration

The entire fitting process can take several appointments spread over 2-4 weeks.

Setting

Typically performed at a specialized prosthetics clinic.

Personnel

• Prosthetist
• Physical therapist (for rehabilitation and gait training)
• Physician (for medical clearance and ongoing care)

Risks and Complications

• Skin irritation or sores on the residual limb
• Improper fitting leading to discomfort or gait issues
• Mechanical failure or wear and tear of the prosthesis

Benefits

• Improved mobility and the ability to perform daily activities
• Enhanced balance and a more natural walking pattern
• Increased comfort compared to less advanced prosthetic options

Recovery

• Initial adjustment period of a few weeks as the patient gets used to the new prosthesis
• Regular follow-up visits to check fit and function
• Routine maintenance of the prosthesis
• Physical therapy to maximize mobility and strength

Alternatives

• Standard single-axis foot prosthesis: Less flexible but functional.
• Energy-storing prosthetic foot: Designed for high-activity levels.
• Microprocessor-controlled prosthetic foot: Advanced option providing dynamic adjustments.

Patient Experience

Patients may experience some discomfort initially as they adapt to the new prosthesis. Over time, proper fitting and adjustments will minimize pain. Physical therapy plays a critical role in easing this transition, improving balance, and ensuring long-term comfort and functionality.