Projecting Prosthetic Needs

I begin with one basic premise. My job is to project what it would cost to return an amputee to his or her pre-amputation style of life given the limitations of prosthetic technology. As a prosthetist, I feel that I’m good at my work (as most of us are), but nothing beats healthy original equipment. However, with proper prosthetic equipment, an amputee today can return to a fairly normal lifestyle that includes a recreational component.

The activity level of an amputee has a tremendous impact on the type of componentry suitable for the individual. In my experience, the more active an amputee, the more prosthetic replacements he or she will require. This is due to wear and tear on components as well as atrophy of the residual limb under the pressure of extra-ambulatory activity. The first step is to determine the activity level of the amputee. A new amputee may not have much of an activity level, but this is not necessarily indicative of their future lifestyle. The best measure of activity level is the amputee’s past activities. If the individual was an athlete or was recreationally active, one can project they will seek to return to that lifestyle. If the individual was sedentary and overweight, it is unlikely he or she will become a competitive athlete.

I use Medicare guidelines in classifying the lifestyle of the amputee. Medicare breaks lifestyle into four categories or K levels. I generally obtain the K level of the amputee from the prosthetic records or by personal interview. What I have discovered throughout the years is that recorded testimony, i.e., medical records or depositions, is a much stronger platform than personal opinion and interviews.

Depositions and medical records can be tedious to read and digest, so I usually reserve 10 to 12 hours to read and annotate these records. From these you can obtain a basis for your claim of lifestyle. I highlight and bookmark references to recreational involvement or any medical condition that may affect lifestyle or residual limb condition. Depositions may have a glossary that can assist you in flagging relevant data contained therein.

The activity level influences the number of replacement prostheses an amputee will generally require. The more active the amputee, the greater the number of replacement prostheses. My experience is that prostheses need to be replaced periodically for anyone, depending on wear and tear, but an active amputee will need replacements more often.