Author Topic: Revision Surgery  (Read 9276 times)

Offline Annie

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Revision Surgery
« on: June 16, 2008, 03:58:28 AM »
Just wondering if anyone on here has gone down the Revision route.  I am considering this at the moment due to many problems with my stump over the last ten years which make it difficult to get a prosthesis fitted.  Am just wondering how long the healing time usually is and how soon they were up and walking.  Am bilateral by the way.

Offline ginger

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Re: Revision Surgery
« Reply #1 on: June 16, 2008, 07:30:55 AM »
Annie,
Sorry to hear that you have to even consider the revision route.  I am a new amp so I really don't know.  I have had to consider it though.  I am a AKA and my limb has healed really strange with a huge fat pad on the interior bottom of the leg making a very strange and uncomfortable fit.
Hope that everything turns out OK.

Ginger
Ginger Henneberger
38 YO  Strykersville, NY
injury 8/28/02
R AKA 8/07
Still recovering, but doing great

Offline pegleg jack

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Re: Revision Surgery
« Reply #2 on: June 16, 2008, 08:46:06 AM »
Ginger, am a bilat bka and from time to time i get the same thing on both of mine and it seem like it happens just after i have been doing a lot of walking or lifting heavy objects, then they disappear for a while, havent discussed this with my doctor because it dosent bother me that much,
you-all have a great day.

Offline Annie

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Re: Revision Surgery
« Reply #3 on: June 16, 2008, 10:05:11 AM »
Well have been bilateral for many years, it has always been on the cards, the original amputation was done in an emergency to save my life after an accident and the below knee bit only saved by extensive skingrafting.  The skingrafting has served me fairly well for almost 40 yrs, but doesn't stand up to the pressures that seem to be required with todays type of limbs.  Have currently been wearing an old fashioned type limb for years, but recently had more and more problems, which the leg now being bonier and the skin graft tighter, and have been advised that now is the right time to go ahead and get this revision done.

Offline Tigertatts

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Re: Revision Surgery
« Reply #4 on: June 16, 2008, 12:16:15 PM »
If you are going to go though the process of revision (and live in the USA) I would highly recommend  the Ertl procedure. -- http://www.ertlreconstruction.com/  --  I had it recommended to me from a lady that had her BK revised to an Ertl (Ertl can  be done both BK and AK) and said the difference was night and day.  After reading the information I couldn't see why you would not get an Ertl, since my amputation I have not had any pain of any kind!! I have NEVER had a single phantom pain and I can currently put around 80-100 lbs of weight on the end of my stump with out any kind of discomfort. The ability to put weight on the end of my stump makes it soooooooo much easier to be fit for a prosthesis. Every day I am thankful that I had the Ertl procedure done and anyone wishing more information on the subject please feel free to ask.  :)

Offline pegleg jack

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Re: Revision Surgery
« Reply #5 on: June 16, 2008, 01:56:15 PM »
Tigertatts, i agree with you in the ERTL procedure, would love to have it done, but have been informed by my insurance company and am waiting on an answer from medicare, that they will not pay for it because of the distance that i have to go to get it done, i live in JACKSONVILLE, TEXAS and the nearest place to have it done is in DALLAS, TEXAS which is a 120 miles from me. There are a lot of peiople in the same boat as i am,  on how far away from a hospital that has a doctor that is trained to do the procedure.
you-all have a great day.

Offline Tigertatts

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Re: Revision Surgery
« Reply #6 on: June 16, 2008, 08:05:56 PM »
Jack -- I live i California and ended up having to fly out to Indianapolis, Indiana to have my surgery done (Jan Ertl ended up moving from California to the University of Indiana from the time I first meet with him and got authorization for him to do my surgery to the time he did my amputation.) When the insurance company found out that I was no longer having it done in California they tried to say that they were NOT going to pay for it because it was out of state (they had preauthorized the entire procedure)so my wife and I got on the plane and just had the surgery done. And once they found out that my entire surgery including hospital stay only cost $22,000.00 (about $35,000.00 cheaper than in California) They were very very fast in paying the bill and never said another word about it. The insurance company also reimbursed us for all our costs, including airfare, hotel stay, parking and transportation to and from the hotel and airport.

 If you have a good surgeon who is willing to learn how to do the Ertl procedure correctly then the Barr foundation offers a video (dvd or vhs) that shows how to do both AK and BK Ertl procedures as revisions or primary operations. The Ertls claim that many surgeons have been able to learn and preform the Ertl procedure from this video. ---  http://www.oandp.com/resources/organizations/barr/barr-donate.htm
« Last Edit: June 16, 2008, 08:31:53 PM by Tigertatts »

Offline Mitchee

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Re: Revision Surgery
« Reply #7 on: June 16, 2008, 09:36:07 PM »
My surgeon had never done an Ertl amputation or even heard of one until I gave him some info and the video of the procedure.  He did some homework and told me that he felt confident in attempting it, so I let him do it.  Someone has to be the first.  lol   It turned out fine and we are both glad and relieved that the outcome has been positive.  As an Ertl, I can bear weight directly on the end of my stump without any pain.  I don't know if this has anything to do with the Ertl procedure but I do not suffer from any phantom pain.
Initial injury:  July 1985
Amputation:  December 2006 - Ertl LBKA

"The journey of a thousand miles must begin with a single step."
 -Lao Tzu

Offline Annie

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Re: Revision Surgery
« Reply #8 on: June 17, 2008, 03:21:06 AM »
No am not living in the USA, and although have taken advice on the Ertl, have been advised that its not suitable for me.

Offline Tigertatts

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Re: Revision Surgery
« Reply #9 on: June 17, 2008, 02:00:37 PM »
Then the best of you luck to you Annie in your search for more comfort.

 P.S. -- the ONLY person that would not be suitable for the Ertl procedure would be a bilateral hipdisartic. If anyone tells you other wise then they know little or nothing about the procedure.

Offline pegleg jack

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Re: Revision Surgery
« Reply #10 on: June 17, 2008, 05:24:47 PM »
tigertatts, feel that you have over step yourself, not everyone is a canidate for the ETRL procedure, i for one am not my left stump is too short , and as it is, it is hard to make a socket for it and if i had the procedure done, there is a chance i would loose some of the movement in myi left knee, and i am not about to have that happen at this time.

And there are other reason for not being a good canidate and that is for medical reasons,

Now take Anne. for exsample, there  may be other pressing medical reason that they have told her that she is not a good canidate for the procedure, so one can not say that everyone is able to have it done. And i have read and talk to quite a few that have had it done and i wish that i to could have it done, but right now i have other pressing problems and dont need to take on my insurance company to get them to pay for it, the fact that i would have to travel.
you-all have a great day.

Offline Tigertatts

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Re: Revision Surgery
« Reply #11 on: June 17, 2008, 06:57:17 PM »
Not starting an argument here I only mean to help educate so please bear with me ,  Everyone seems to think that the "Ertl" is the "bone bridge" between the tib and the fib, this is only one small part of the procedure and only for below knee applications where this is feasible. Where there are 5 major aspects to the procedure and 4 of those 5 can help make any amputee more functionable and comfortable.

 The Ertl Procedure:  1- The Bony Bridge , re-establish medulary pressure by capping the end of the bone (adding the bridge between the tib and fib if BK)
2-Treating the vessels, Arteries and veins isolated, and separately ligate. 3- Treating the Nerves, distract, transect, retract into soft tissue to re-establish the gliding mechanism. (this is why many Ertl patients don't have phantom pain),  4. Myoplasty abductors to adductors medial to lateral to re-establish pumping action and to create a pad. 5- Contour skin, smooth contour with no "dog ears" to make for a better fit in a prosthesis

Offline Mitchee

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Re: Revision Surgery
« Reply #12 on: June 17, 2008, 09:46:10 PM »
Thanks Peg Leg Jack and Tigertatts for your replies.  Thanks PLJ for pointing out that an Ertl amputation/revision isn't for everyone.  Tigertatts thanks for adding the additional info about what an Ertl amputation encompasses. 

As an Ertl amputee, I can say that it isn't for everyone.  If you have been involved in an accident (auto, industrial, etc.)  the surgeon doesn't always have a lot to work with so an Ertl may not be appropriate.  It also isn't used in individuals who have a history of healing problems (circulation, etc.) or problems with anesthesia.  It takes longer to do an Ertl amputation and the longer anesthesia is a problem for some individuals.  I have found, through my own research, that not all surgeons are familiar with the Ertl procedure and those that are don't necessarily consider it to be worth THEIR extra effort.   And finally, many people facing amputation or revision surgery are not able to get their insurance companies to cover the costs.  Health insurance companies don't care about the long term benefits for amputees.  They are interested in paying for the cheapest procedure.  There are also many other reasons why an individual may or may not be a candidate for an Ertl amputation or revision.  Your concerns should be thoroughly discussed and addressed with your surgeon before deciding an appropriate course of treatment. 

My surgeon completed all 5 parts of the Ertl amputation and I am grateful.  I would to see those that are good candidates for the procedure have access to it!!

Good luck to everyone who is facing an amputation or a revision. 

Michelle
Initial injury:  July 1985
Amputation:  December 2006 - Ertl LBKA

"The journey of a thousand miles must begin with a single step."
 -Lao Tzu

Offline Annie

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Re: Revision Surgery
« Reply #13 on: June 18, 2008, 03:06:52 AM »
Yes there were other reasons for me not being recommended the Ertl.  Also I live in England, and its still very new over here and I do have an already quite short and skin grafted stump and have already been told because of this healing will be a problem.  However, agree that the Ertl does appear to have very definite benefits and when I come to look at my other stump in a couple of years time, which is longer and not grafted I may be considering it.

Offline pegleg jack

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Re: Revision Surgery
« Reply #14 on: June 18, 2008, 08:41:09 AM »
Anne and Mitchee, thanks for backing me up on this. I was not trying to start and argument with anyone, but was just stating the facts in an answer to his statement.

Tigertatts, I was not putting you down and am sorry if you toke it that way. Your information about the ERTL procedure is the same as what i have. And as i stated before i would love to have it done, but am unable to.
It would increase my activity level 3 fold and i could possibly go back to work, which i would love to do now that i am 65 and am on regular social security instead of disability social security, and there is a big difference between the two.
you-all have a great day.