Tips to know before fitting a prosthesis

What is a K Level?

A K level is a scale used by Medicare to rate your rehabilitation potential. Many private insurance companies follow Medicare’s example to establish coverage guidelines. The K level is a rating from 0 to 4 that is used to predict your potential success with your prosthesis. It may change over time as you improve in your ability to wear and use the prosthesis. The K level is important because it is used by your insurance company to figure out what type of prosthetic device and specific components like the knee and foot, they will cover for you. Insurance companies want to know that the prosthesis you receive will be appropriate and functional. The potential function of your prosthetic device is determined by your pre- and post-amputation capabilities and goals in order to create a full picture of your functional abilities and any limitations you may face on a typical day. Your doctor will complete an assessment of your physical and cognitive abilities to determine your K level. The different K Levels are:

K0 Level: Does not have the ability or potential to ambulate or transfer safely with or without assistance. A prosthesis does not enhance quality of life or mobility.

K1 Level: Has the ability or potential to use a prosthesis for transfers or ambulation on level surfaces at fixed walking speeds. Typical of the limited and unlimited household ambulator.

K2 Level: 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 Level: Has the ability or potential for ambulation with variable cadence. Typical of the community ambulator who has the ability to traverse most environmental barriers and may have vocational, therapeutic, or exercise activity that demands prosthesis use beyond simple locomotion.

K4 Level: Has the ability or potential for prosthesis ambulation that exceeds basic ambulation skills, exhibiting high impact, stress, or energy levels. Typical of the prosthetic device demands of the child, active adult, or athlete.

A Note on Phantom Limb Pain

Phantom limb pain, or pain that seems to come from the amputated limb, is a very real problem that you may face after an amputation. “About 80% of people with amputations experience phantom limb pain that has no clear cause, although pain in the limb before amputation may be a risk factor,” says Keszler.

Mirror therapy, where you perform exercises with a mirror, may help with certain types of phantom limb pain. “Looking at yourself in the mirror simulates the presence of the amputated leg, tricking the brain into thinking it’s still there, stopping the pain,” explains Keszler.

In other cases, phantom limb pain might stem from another condition affecting the residual limb, such as sciatica or neuroma. Addressing these root causes can help eliminate the phantom pain.

Your Leg Prosthesis Needs May Change

At some point, you may notice that you aren’t as functional as you’d like to be with your current leg prosthesis. Maybe your residual limb has stabilized and you’re ready to transition from a temporary prosthesis that lasts a few months to one that can last three to five years. Or maybe you’ve “outwalked” your prosthesis by moving more or differently than the prosthesis is designed for. New pain, discomfort and lack of stability are some of the signs that it may be time to check in with your prosthetist to reevaluate your needs.

Your prosthetist might recommend adjusting your current equipment or replacing one of the components. Or you might get a prescription for a new prosthetic leg, which happens on average every three to five years. If you receive new components, it’s important to take the time to understand how they work. Physical therapy can help adjust to the new components or your new prosthetic leg.

Prosthetic Leg Technology Is Always Evolving

There are always new developments in prosthetic limb technology, such as microprocessor-driven and activity-specific components.

Microprocessor joints feature computer chips and sensors to provide a more natural gait. They may even have different modes for walking on flat surfaces or up and down the stairs.

There are also specialized prosthetic legs for different activities, such as running, showering or swimming, which you can switch to as needed. In some cases, your everyday prosthetic leg can be modified by your prosthetist foot axis to serve different purposes.

Osseointegration surgery is another option. This procedure involves the insertion of a metal implant directly into the bone, so there is no need for a socket. The prosthetic leg then attaches directly to that implant. While this procedure is not right for everyone and is still under study, it can provide improved range of motion and sensory perception.

It’s important to remember that you’re not alone in navigating the many different prosthetic leg options. Your care team will help you weigh the pros and cons of each and decide on the ideal prosthetic leg that matches your lifestyle.