Name of the Procedure

Common Name: Multi-Axial Rotation Unit for Lower Extremity Prostheses
Technical Term: HCPCS Procedure L5986

Summary

A multi-axial rotation unit ('mcp' or equal) is an advanced component used in lower extremity prostheses to provide improved movement and flexibility at the joint. This allows amputees to walk more naturally and comfortably, particularly on uneven surfaces.

Purpose

The multi-axial rotation unit is designed to enhance the functionality of lower extremity prostheses by allowing more realistic joint movements. It helps address issues like limited mobility and discomfort in prosthetic users, aiming to improve their overall quality of life and ability to perform daily activities.

Indications

This procedure is appropriate for patients with:

• Amputations above or below the knee.
• Difficulty in achieving a natural gait with a single-axis prosthesis.
• Frequent walking on uneven terrain, leading to discomfort or instability.

Preparation

• Patients should undergo a thorough evaluation by a prosthetist to assess their suitability for a multi-axial rotation unit.
• No specific fasting or medication adjustments are typically required.
• Relevant medical history and lifestyle assessments may be conducted.

Procedure Description

1. Assessment: A detailed assessment of the patient's prosthetic requirements and current limitations.
2. Fitting: Selection and customization of the multi-axial rotation unit to fit the existing or new prosthesis.
3. Attachment: Securing the unit to the lower extremity prosthesis.
4. Adjustment: Fine-tuning the unit for optimal performance, which may include trying different settings to ensure comfort and functionality.
5. Testing: Initial walking tests to make necessary adjustments for a natural gait.

Tools/Equipment: Multi-axial rotation unit, prosthetic limb components, fitting tools.

Duration

The fitting and adjustment process typically takes a few hours, including assessment and initial walking tests.

Setting

The procedure is usually performed in a specialized prosthetic clinic or outpatient facility.

Personnel

• Certified Prosthetist or Orthotist
• Supporting clinical staff (e.g., nurses, physical therapists)

Risks and Complications

• Common Risks: Temporary discomfort during the adjustment period.
• Rare Risks: Skin irritation, misalignment leading to pain, mechanical failure of the unit.
• Management: Regular follow-ups and adjustments to address any issues.

Benefits

• Enhanced mobility and comfort due to improved joint movement.
• Ability to walk more naturally, even on uneven surfaces.
• Increased confidence and independence in daily activities. Patients typically experience these benefits within a few weeks of fitting and adjustment.

Recovery

• Patients might experience a brief adaptation period with some initial discomfort.
• Instructions on care and maintenance of the prosthesis will be provided.
• Follow-up appointments for adjustments and monitoring progress.
• Recovery time is minimal, typically involving adapting to the new movement capabilities.

Alternatives

• Single-axis prosthetic joints: simpler but less flexible.
• Polycentric prosthetic knees: offer stability but might not provide multi-directional movement.
• Pros and Cons: Single-axis and polycentric joints are less complex and more durable but do not offer the same range of motion and adaptability as multi-axial units.

Patient Experience

• During the Procedure: Minimal discomfort, primarily related to adjustment and fitting.
• After the Procedure: Initial period of adaptation with possible temporary discomfort as muscles adjust. Pain management measures include over-the-counter pain relievers and specific exercises for acclimation.
• Physical therapy may be recommended to help the patient adapt to the new prosthetic component and maximize its benefits.