non-microprocessor options for Hip Disarticulation? and Trial dilemma?

non-microprocessor options for Hip Disarticulation? and Trial dilemma?

William Lifford

3/28/2022

Hello colleagues,

I have a hip disarticulation amputee patient who, for a variety of reasons,
will most likely not be able to get auth for a microprocessor-controlled
knee. Honestly, I can't remember in my career ever doing a hip disartic or
hemipelvectomy without an MPK... I've been lucky enough to have had active
patients who were easy MPK candidates. Who among you has done K2-level MPK
fittings and had good success, and can you help me figure out what hip and
knee options work best together?

ALSO: so part of the problem is that the patient has no prosthesis at all
currently -- it's a long story, but the prosthesis is lost in a
foreign country -- and the insurance will only approve an MPK if the
patient does a trial of a non-MPK system versus an MPK system, (and if the
results show she does better with the MPK, of course). But she has no
socket with which to do a trial. And they want the results of the trial
in less than two weeks.

How do you approach this? Get auth for a socket first, then do a trial?
or get auth for a K2 prosthesis, then do a trial? It's complicated because
it's quite a large socket (even by hip disartic standards) and it's not
something I could fabricate in my lab -- I would have to send it out.
There's no way I could have a socket ready for a trial within the two weeks
anyway, as I haven't even casted her yet. Make a BK or an AK socket quick
for a trial, that's easy, but this is a whole order of magnitude bigger
job. And more complicated, with more cost involved.

Thanks in advance for any advice you can give!

Bill Lifford, CP


--
*William Lifford, CP*
*American Board Certified Prosthetist*
*The Goodman Center for Advanced Prosthetics*
*(a part of Progressive Orthotics, Ltd.)*
280-G Middle Country Road
Selden, NY 11784
work: (631) 732-5556, fax: (631) 732-0218
cell: (631) 304-6113