Replies: Post surgical Prosthesis or Definitive? Part II

Replies: Post surgical Prosthesis or Definitive? Part II

Jeremy Sprouse

3/8/2013

Work more closely with the patients physical therapists in the process.

Teach them how to use the Amputee Mobility Predictor.

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We do strictly definitive post op...and have found that it costs the payer
about the same but better for the patient.

 

as far as determining K-Level..

 

the way I look at it (and bear with me as I'm a newly minted CP) is the
potential for the patient's ambulatory status. I tend to think that if a
person was a K2 before their amputation they probably won't be a K3 after
their amputation. K4 is so rare anyway that you'd be certain that the
patient would be a K3 for componentry selection-purposes. So that leaves K2
v. K1. If a patient was able to ambulate before their amputation then I
think they have the potential to ambulate after their amputation.

 

'hope that was helpful. I've had to discuss my decision to place a (K3)
patient into a definitive as a post-op with an insurance adjuster. And once
explaining that the patient was more stable, had a higher likliehood of
succesful rehabilitation, no SACH went into the trash, and the first socket
lasted a few months anyway they happily paid.

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Good morning Jeremy,

 

Interesting thoughts and questions. As I'm sure you are aware, determining
K: level is in some ways the primary goal of clinical preparation. In
fact, its most likely the only way scientific method of determining
appriproate and suitable K level function. Along with a lot of other
considerations, the preparatory stage provides the opportunity to evaluate
different types of feet, to include SACH designs. I have attached a 1200
word white paper and 8500 word manuscript to this effect. Of particular
interests in the manuscript would be references 18 thru 23.

I can forward the papers if anyone would like them

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I would explore using the AMP, Amputee Mobility Predictor to document
ability or potential for K-level. We also provide the definitive and then a
socket change within the first year. It makes more sense form a materials
stand point and I've always felt that the benefits of a dynamic foot are so
much more than a SACH. Attached is Robert Gailey's paper of amputee
mobility.

Hope it helps,

Again I will forward paper to anyone whom would like it.

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We make a thermoplastic prep with a SACH for all our patients to give them
time to shrink and to justify K level for a definitive. Per the Medicare
seminar, they have to be in the prep for 3-6 months prior to making the
definitive.

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Thanks again to all who replied.

 

 

Jeremy Sprouse CPO