Knee Immobilizer

Knee Immobilizer 

Purpose: 

To promote extension and support knee components following a total knee replacement or fracture of the patella, distal femur, or proximal tibia. 

Procedure: 

The application of a knee immobilizer must be performed by licensed staff, CNAs who have been trained, PT, OTR, or COTA with a physician's order under the following guidelines: 

I. Application: 

• The large end should be placed proximally 3 inches from the ankle. 

• The smaller end should be placed distally 2-3 inches from the ankle. 

• Velcro straps should be tightened, allowing one (1) finger to fit comfortably into the top and bottom. 

• The knee immobilizer can be worn over or under the resident’s pant leg. 

• The skin under the immobilizer should be assessed prior to donning and after removing the immobilizer. 

II. Wearing Schedule: 

• A specific physician order is necessary regarding when the knee immobilizer should be worn. 

• Discharging use of the knee immobilizer: The resident is discharged with the knee immobilizer when specifically ordered by the physician. 

• The facility will provide the resident/family with written instructions regarding the use of the immobilizer. 

III. Documentation: 

• When carried out by nursing, the application and removal of the knee immobilizer will be documented on the Treatment Kardex. 

References: 

• Centers for Medicare & Medicaid Services (CMS), Requirements of Participation for Long-Term Care Facilities. 

• State Operations Manual (SOM), CMS. 

• Facility-specific training protocols for licensed staff, CNAs, PT, OTR, and COTA.