Name of the Procedure:

Common Name: Lower Limb Prosthesis with Axial Rotation Unit
Medical Term: Endoskeletal Lower Extremity Prosthesis, Axial Rotation Unit, with or without Adjustability (HCPCS Code: L5984)

Summary

This procedure involves fitting a patient with a sophisticated prosthesis for the lower extremity. The prosthesis includes an axial rotation unit, which allows for greater mobility and natural movement, mimicking the rotational capabilities of a real leg.

Purpose

Medical Conditions Addressed:

• Amputation of the lower extremity due to trauma, disease, or congenital conditions.
• Enhancement of mobility and quality of life for patients requiring artificial limbs.

Goals:

• To restore functional mobility.
• To provide rotational flexibility for more natural movements.
• To improve balance, gait, and overall daily activity performance.

Indications

Specific Symptoms or Conditions:

• Patients with unilateral or bilateral lower extremity amputations.

• Individuals who perform activities that require rotational flexibility of the limb.

  Patient Criteria:

• Adequate physical health to manage the prosthesis.
• Clear understanding and ability to comply with post-procedure rehabilitation and maintenance.

Preparation

Pre-Procedure Instructions:

• No specific fasting required.
• Patients may need to stop certain medications as advised by the healthcare provider.
• A thorough physical examination and assessment to determine suitability.

Diagnostic Tests:

• Imaging studies like X-rays or MRI to understand the stump's condition.
• Gait analysis.

Procedure Description

1. Assessment and Customization: Patient undergoes a detailed assessment for a custom-fit prosthesis.
2. Casting or Scanning: The residual limb is cast or scanned to create a mold.
3. Prosthesis Fabrication: The prosthesis, including the axial rotation unit, is crafted.
4. Fitting and Adjustment: The custom prosthesis is fitted to the patient, and adjustments are made to ensure comfort and functionality.
5. Alignment and Testing: The prosthetic is aligned properly; patient performs walking tests to confirm fit and adjustability.

Tools and Equipment:

• Molding materials or 3D scanners.
• Prosthetic components including axial rotation units.
• Alignment tools and fitting equipment.

Anesthesia:

• Typically no anesthesia is required.

Duration

The entire process, from assessment to final fitting, can take several weeks to months, with individual fitting sessions lasting 1-3 hours.

Setting

• Orthopedic or prosthetic clinics.
• Outpatient rehabilitation centers.

Personnel

• Prosthetist
• Orthopedic surgeon (if surgical adjustments are needed)
• Physiotherapist

Risks and Complications

Common Risks:

• Skin irritation or pressure sores.
• Initial discomfort as the patient gets used to the prosthesis.

Rare Risks:

• Infection.
• Misalignment requiring readjustment.

Management:

• Regular follow-up visits to make adjustments.
• Proper hygiene and care of the stump and prosthesis.

Benefits

Expected Benefits:

• Enhanced mobility and range of motion.
• Improved quality of life and independence.
• More natural gait and movement.

Realization Time:

Benefits typically begin within weeks of proper fitting and rehabilitation.

Recovery

Post-Procedure Care:

• Regular cleaning and maintenance of the prosthesis.
• Guided physical therapy to adapt to the new limb.

Expected Recovery Time:

• Adaptation period of several weeks to months.

Restrictions:

• Avoid extreme physical activities early on.
• Follow specific exercise and care routines as instructed.

Follow-Up:

• Regular appointments with the prosthetist.
• Periodic evaluations to adjust the prosthesis as needed.

Alternatives

Other Treatment Options:

• Non-axial rotational prosthetics (may offer less flexibility).

• Wheelchairs or crutches for mobility support.

  Pros and Cons:

• Non-axial Rotational Prosthetics: Less expensive but may limit movement.
• Wheelchairs/Crutches: No need for fitting, but limit physical activity and independence.

Patient Experience

During the Procedure:

• Typically no pain.
• May feel pressure during fitting and adjustment.

After the Procedure:

• Initial soreness or discomfort during the adaptation phase.
• Pain management through over-the-counter medications if needed.

Comfort Measures:

• Special liners and padding to enhance comfort.
• Regular checks and prompt adjustments to alleviate any issues.

This covers the key elements of the procedure for fitting an endoskeletal lower extremity prosthesis with an axial rotation unit. It is designed to offer both technical details and understandable information for patients and medical practitioners.