Eighteen years after having his left leg amputated as a toddler, a U.K. man paid 64,000 British pounds (C$100, 000) to have his remaining leg amputated in order to undergo a surgery he had only seen performed on man’s best friend — and only on television.
James Bertrand said he sought out a surgeon who could perform osseointegration surgery after seeing a dog undergo the procedure in a 2016 episode of The Supervet.
Osseointegration is a procedure in which a surgeon attaches a prosthetic by inserting a titanium rod into the bone of the amputated limb.
Bertrand told Global News he immediately wondered if the surgery could be performed on humans.
“I didn’t even know that this kind of technology existed,” he said.
The 20-year-old said the search led him to a doctor in Australia who was one of only a small group of surgeons who could perform the procedure.
Dr. Munjed Al Muderis told Global News his medical practice in Australia has performed roughly half of all cases of osseointegration surgery worldwide.
Other centres that perform the surgery exist in Sweden and Germany. There is also a trial program at Walter Reed National Military Medical Center in Bethesda, Md.
But Al Muderis says the surgery is “still in its infancy.”
The surgeon told Bertrand he couldn’t perform the osseointegration surgery on his already amputated leg as the 20-year-old had hoped.
“He said he wouldn’t do the surgery on my left leg unless I had my right leg amputated, too,” Bertrand explains.
Al Muderis told him his right leg was too damaged to support his weight.
Bertrand, who has an identical twin brother, has had chronic pain in his right leg since he was a toddler. He and his brother were born with a condition called twin-to-twin transfusion syndrome.
The rare condition can occur when twins share a placenta and the blood flow becomes unequal.
For Bertrand, that meant an excess of blood, which led to clotting in his legs when he was a newborn.
He had his left leg amputated at 18 months and has had severe problems with his right leg his entire life.
“I lost all the fat and muscle tissue in my calf downwards,” Bertrand says. “My foot was in a fixed position so I had no flexibility in the ankle at all.”
Bertrand said he couldn’t even walk on a hardwood floor without shoes because the pain in the ball of his foot was so severe.
“It was just excruciating, to be honest.”
He had the surgery on May 31.
Bertrand told Global News that undergoing osseointegration surgery was one of the “most difficult decisions I’ve had to make.” He said it’s a decision with which he still wrestles.
“I was on crutches for five months,” he says. “I’ve had 30 operations in my life and this has, by far, been the toughest.”
Al Muderis told Global News that osseointegration surgery offers “many opportunities” for people with disabilities — including amputees — as well as people suffering from spinal cord injuries and cerebral palsy. But there are also risks associated with the procedure.
“Infection is the main risk, considering that it’s a piece of metal sticking out of the skin,” explains Al Muderis.
“We have to make sure that area is very well protected, and we have designed surgical techniques and implant technology that minimize the risk of infection by special coating of the implants and special soft tissue management.”
Al Muderis says there are patients to whom he would not recommend the surgery, including those who have had chemotherapy or radiation.
Smoking, too, is a problem because of the impact on blood pressure. Al Muderis says poor circulation can increase the risk of infection, making the surgery more dangerous.
In Bertrand’s case, Al Muderis said that circulation to his leg had improved even as it continued to cause him problems.
Bertrand says he has started to see benefits months after the surgery. And he jokes that he was able to “choose” his height and shoe size.
“My brother’s six foot, and I was always a lot smaller than him so now we’re almost identical heights, which is a good feeling,” he said.
Bertrand raised the money for the surgery himself and donated 10 per cent of what he collected to the Great Ormond Street Hospital in London.