Category Archives: Prosthetics

How to help your patient find a prosthetist

Choosing a Prosthetist

A Guide for Medical Professionals

Referring a patient to Collier means they will receive ongoing care recommendations as they work towards their rehabilitation goals. After a patient is referred, our job is to evaluate the fit and function of the prosthesis. We can then discuss options that will allow them to find the prosthetic configuration option that will allow them to reach their goals as well as the information their insurance company will require.

Are your amputee patients overwhelmed and frustrated with the process of getting their prosthesis?

Are they currently in a prosthetic socket that is uncomfortable and difficult to wear?

Does your patient feel secure and safe with how their prosthesis functions?

Are they able to use their prosthesis to achieve their goals in life?

If you have a patient that currently has an ill-fitting prosthesis or one with components which do not provide optimal fit or function, they will need a new prescription. New documentation needs to reflect the patient’s current and potential physical condition, their K-level and problem with their current device. Past documentation should be in place for existing patients which speeds up the process.

Document

Evaluation Checklist for Physician

  • Physical Exam
  • History of Amputation
  • Functional Deficits
  • Functional Level
  • Motivation to use prosthesis
  • Describe the condition of the residual limb
  • Patient’s past experience with prosthesis

If a replacement prosthesis is needed, describe the condition of current prosthesis or component and your recommendation based on your functional level evaluation.

Diagnose

Confirm the K-level. Centers for Medicaid services physician letter.

K1 – Functional Level 1

The patient has the ability or potential to use a prosthesis for transfer or ambulation on level surfaces at fixed cadence.

K2 – Functional Level 2

The patient has the ability or potential for ambulation with the ability to traverse low-level environmental barriers such as curbs, stairs or uneven surfaces. Typical of the limited community ambulator.

K3 – Functional Level 3

The patient has the ability or potential for ambulation with variable cadence. Typical of the community ambulator who has the ability to navigate most environmental barriers and may have vocational, therapeutic or exercise activity that demands prosthetic utilization beyond simple locomotion.

K4 – Functional Level 4

The patient has the ability or potential for prosthetic ambulation that exceeds basic ambulation skills, exhibiting high impact, stress or energy levels. Typical of the prosthetic demands of the child, active adult, or athlete.

Collaborate

The Collier prosthetist collaborates with the rehabilitation team, physician(s), therapist, patient and family members to provide improved prosthetic care for each patient. This collaboration will help develop short and long-term goals through their journey to better help them improve their prosthetic progress and outcomes.  During this transparent process with the team, the patient becomes well educated through the thorough communication with all members. Collective input from all team members creates a clear plan for better patient outcomes, which leads to higher patient satisfaction with improved functional results.

Why should you choose a Collier Prosthetist? Patients are our First Priority.

Collier Prosthetic Patient Care — How to Choose a Prosthetist

 

We understand that every patient is unique, physically and psychologically and we have the experience and compassion to guide them through this journey.

We have gathered some resources that might help your patients when they have questions that might be beyond your scope of service.

The Amputee Coalition on preparing your limb for a prosthesis

Upper Limb Loss Questions

Certification Boards

The American Board for Certification in Orthotics, Prosthetics & Pedorthotics (ABC)

abcop.org
info@abcop.org
703-836-7114

The Board of Certification/Accreditation, International (BOC)

bocusa.org

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Prosthetic Case Study – Trans Tibial Amputee

Mikhaila Rutherford is 26 years old and, and with her new prosthesis, she is more ambulatory and ready to enjoy her new career in nursing without the hassles and limitations of her old and worn out prosthetic device.

Four years ago, Mikhaila came to our lead prosthetic practitioner with some challenges:

  1. She would be challenging to fit due to multiple surgeries to resolve her subluxating patella (knee cap).
  2. A short trans tibial residual limb.
  3. Her current foot did not allow for any flexibility when walking on slopes of any kind.

George was able to get approval through the insurance for the best possible device for Mickhaila. Watch the video to see how Mickhaila demonstrates her new prosthesis with an articulating ankle.

She was fit with an Alps AKDT locking liner and Patellar Tendon Bearing Supra Patellar Supra Condylar (PTB SCSP) socket design to help stabilize her knee in the medial lateral plane. For her last fitting, she was provided a foot with an articulating hydraulic ankle which can accommodate going up and down sloped terrain.

Mickhaila can now get back to daily living with a lot more mobility when hiking and being outdoors. We look forward to hearing about her new career as a nurse when she comes back for a check up.

 

Mickhaila has been a patient of George Villarruel at Collier O and P for the last 4 years. If you would like to see more of our patient success stories, visit our patient outcomes page.

Learn more about Collier’s patient care philosophy, where the patient needs are always the first priority.

 

 

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Prosthetics – Hip Flexion Case Study

Hip Flexion Case Study

hip flexion case study prostheticsAlthough this is a dramatic depiction of a transfemoral patient with a significant hip flexion contracture, it is something many above knee amputees and their prosthetist deal with to various degrees. A Thomas test would show that this patient has a contracture of approximately 35 to 40 degrees.

The picture on the left shows the weight line or TKA line, bisecting the socket with the center of his mechanical knee so far in front of the line that weight bearing on this alignment would certainly cause the patient to feel unstable and possibly collapse. Even if the patient could stand on this alignment it would create a lordosis or arching of his lower back. He would be in pain in no time as his lordosis compensates for the lack of hip flexion aligned onto this prosthesis.

By simply adding a flexion plate to his existing alignment (purple arrow) the patient can now stand on his prosthesis with greater stability and confidence.

The weight line on the picture on the right shows it bisecting the socket and going slightly anterior to the center of his mechanical knee and down to the middle of his foot creating an inherently stable alignment from which the patient can feel safe ambulating on.

 

George is an American Board Certified Prosthetist with over 25 years of experience focused solely in the practice of prosthetics. As the Director of Prosthetics for Collier, he is responsible for lower and upper extremity prosthetic patient care. His experience ranges from infancy to geriatrics.

Do you have a question for George? Email George your question.

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Earn CEC Credits at no cost to you!

collier cec courses

Collier O and P Practitioners will come to your location and teach continuing education classes.

 

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Contact us about upcoming course dates.

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Pediatric Prosthetic Patient Resources

Prosthetic and Orthotic Resources for Families

We have put together some links which you may want to explore to learn more about your child’s condition or find support for your child with a prosthesis. Please remember Collier is not affiliated with these websites, and that there is no substitute for a practitioner who listens to your needs.

Collier practitioners make themselves available for questions of any kind regarding your child’s prosthesis. Many patients have come to us, and with a few corrections to their prosthesis, are thrilled to have options that were not offered with their previous practitioner.

 

Association of Children’s Prosthetic-Orthotic Clinics

Patient Information: acpoc.org/patient-info/

 

Amputation Coalition of America

amputee-coalition.org

 

Pediatric Patient Social Connections:

facebook.com/SammysFriends

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