Transtibial (Below Knee)

A transtibial prosthesis replaces the function of missing anatomical segment(s) from below the knee to the floor. This excludes partial feet .

The way we do it	The prosthetic socket is the main connection between the residual limb and the prosthesis. It is the socket that must distribute the forces through the residual limb. The more intimate the socket the better the function and comfort of the prosthesis. The socket can be suspended in numerous ways including: Suspension sleeve Supracondylar Elevated vacuum Locking liner
Prosthetic Treatment Pathway	The patient is assessed by the Certified Prosthetist to determine what would be the most suitable interface, socket design, suspension method, foot, and cosmesis. The most appropriate prosthesis for a patient is based on a physical examination, history, and interview. A typical prosthesis will consist of an interface (link to glossary), socket, suspension modality (see above ), a prosthetic foot, and a connection between the socket and the foot. The shape of the residual limb is captured The cast is modified to allow weight bearing in appropriate areas A diagnostic socket is made to evaluate the function and comfort of The prosthesis is evaluated by a Certified Prosthetist: The patient is taught how to properly don the prosthesis Volume of socket assessed Pressure distribution is assessed Suspension of the prosthesis is assessed Static alignment of the prosthesis assessed Dynamic alignment of the prosthesis assessed Skin of patient assessed The patient is educated on the prosthesis The patient may wear the temporary prosthesis for a period of time to ensure it is optimal. After some follow up and reviewing all of the above criteria a definitive prosthesis is made and provided
Continued Care	Many patients are fit with prosthetic gel liners these can be washed everyday using a mild soap and water. It is important that all the soap is washed from the liner as residue can irritate the skin. After a prosthesis is first fit the patient usually requires some gait training. The patient wears the prosthesis and contacts the Certified Prosthetist with any issues Tissue redness that does not go away following 30 minutes from doffing. Discomfort Signs of wear on the prosthesis Patient(s) may require additional prosthetic training with an occupational or physical therapist. The body is constantly changing but the prosthesis is not. Due to the change in volume over time or throughout the day an individual may have to accommodate a loss in volume with a sock. To maintain volume and stop swelling overnight a shrinker sock may be worn.
Funding	Alberta Aids to Daily Living The Alberta Aids to Daily Living (AADL) program helps Albertans with a long-term disability, chronic illness or terminal illness to maintain their independence at home, in lodges or group homes by providing financial assistance to buy medical equipment and supplies. An assessment by a health care professional (Orthotist or Prosthetist) determines the equipment and supplies that an Albertan can receive through this program. Albertans pay 25% of the benefit cost to a maximum of $500 per individual or family per year. Seniors, low-income Albertans, and those receiving income assistance are exempt from paying the cost-sharing portion. For some benefits, clients may choose an upgraded item and must pay the additional cost of this item. These additional costs are not included in the $500 cost-share maximum. You may be eligible for benefits through AADL if you: Are an Alberta resident with a valid Alberta HealthCare Insurance Plan Require assistance because of a long-term disability, chronic illness or terminal illness. Long-term and chronic are defined as being six months or longer. Below is a guide as to the details required for a potential approval: Prescription that includes the following: Dated within the last three months for AADL, one year for other Specifies what device(s) you require (i.e. – custom knee brace, custom AFO) Specifies the region and limb that is affected (i.el. – left knee, right wrist) Has a medical diagnosis (i.e. – osteoarthritis, multiple sclerosis) Signed by a physician (some items require a specialist) with physician address information For some custom knee braces through AADL we require a copy of your: X-Ray Report (weight bearing position preferred) or MRI Report AADL would be direct billed for treatments provided on your behalf Visit Alberta Aids to Daily Living website for more details regarding the AADL program including forms can be found › Workers’ Compensation Board (WCB) - Alberta Every hour, Albertans are injured on the job. The Workers’ Compensation Board - Alberta is a not-for profit organization that helps injured workers return to work as quickly and as safely as possible. I some cases foot orthotics and various bracing (i.e. knee, back, etc.) is required to return to work. In most cases our members will work with the prescription you received from a physician and determine what to recommend. Then your WCB case worker would be contacted to secure approval for the item you require. Most items requested are established within the contract and fee guide that is negotiated between membership and WCB – Alberta. In some cases a special request is required for items not contained within the fee guide. WCB would be direct billed for treatments provided on your behalf Visit WCB - Alberta’s website for more details › Non-Insured Health Benefits (NIHB) Program Health Canada's Non-Insured Health Benefits (NIHB) Program provides a limited range of medically necessary health-related goods and services to eligible registered First Nations and recognized Inuit, when these goods and services are not already provided through private insurance plans, provincial or territorial health and social programs, or other publicly funded programs. NIHB Program benefits include a specified range of medical supplies and equipment (i.e. orthotics, custom footwear, prosthetics); prescription drugs and over-the-counter medications; dental and vision care; short-term crisis mental health counseling; and transportation to access medically required health services that are not available on the reserve or in the community of residence. The Program also funds provincial health premiums for eligible Clients in British Columbia. The Provider Guide for Medical Supplies and Equipment (MS&E) Benefits explains the terms and conditions, the policies, and the benefits under which the NIHB Program will reimburse medical supplies and equipment provided to eligible Clients. As policies and procedures evolve, the guide is updated accordingly and providers are advised of these changes through the Program's newsletters and bulletins. NIHB would be direct billed for treatments provided on your behalf Vist the NIHB website to learn more about the program › Veterans Affairs Canada (DVA) Provides coverage for prostheses, orthoses, and other related accessories. Repairs to equipment are obtained under this program. Like most paying agents our members require prior approval before providing any items. Pre authorization paperwork will need to be completed and submitted to pursue any funding available. DVA would be direct billed for treatments provided on your behalf. Examples of benefits covered: Arch supports (foot orthotics) Artificial limbs (prosthetics) Leg/arm braces Modifications to ordinary footwear… Visit the Veterans Affairs website to learn more › Private Insurance Funding available from private insurance companies varies a great deal and how our members interact with third party insurers would also vary. Please speak directly with any of our members in regards to any specific third party insurance related questions you may have.