Note (1): The term “prosthetic replacement” in diagnostic codes 5051–5053 and 5055–5056 means a total replacement of the named joint. However, in DC 5054, “prosthetic replacement” means a total replacement of the head of the femur or of the acetabulum.
Note (2): When an evaluation is assigned for joint resurfacing or the prosthetic replacement of a joint under diagnostic codes 5051–5056, an additional rating under § 4.71a may not also be assigned for that joint, unless otherwise directed.
Note (3): Only evaluate a revision procedure under diagnostic codes 5051–5056 if it involves a total replacement of the joint.
Note (4): The 100 percent rating for 1 year following implantation of prosthesis will commence after initial grant of the 1-month total rating assigned under § 4.30 following hospital discharge.
Note (5): The 100 percent rating for 4 months following implantation of prosthesis or resurfacing under DCs 5054 and 5055 will commence after initial grant of the 1-month total rating assigned under § 4.30 following hospital discharge.
Note (6): Special monthly compensation is assignable during the 100 percent rating period the earliest date permanent use of crutches is established.
| Rating Criteria | Evaluation Percentage |
|---|---|
| 5055 – Knee, resurfacing or replacement (prosthesis): | |
| For 4 months following implantation of prosthesis or resurfacing | 100 |
| With chronic residuals consisting of severe painful motion or weakness in the affected extremity | 60 |
| With intermediate degrees of residual weakness, pain or limitation of motion rate by analogy to diagnostic codes 5256, 5261, or 5262. | — |
| Minimum evaluation, total replacement only | 30 |