Amputee Treatment Center Forum

GENERAL CATEGORY => General Discussion => Topic started by: herb on March 01, 2009, 01:13:38 PM

Title: above knee ertl procedure
Post by: herb on March 01, 2009, 01:13:38 PM
I was wondering if anyone here has had an above knee ertl amputation. Can you let me know what you think of it, does it do what it is supposed to do, how fast is recovery, can you weight bear on the end of your residual leg, how fast were you in a prosthesis. thanks, herb
Title: Re: above knee ertl procedure
Post by: Tigertatts on March 01, 2009, 02:10:54 PM
 I've heard there are some issues with muscle ends comming undone with Ertl AK's. I am an Ertl BK and highly recommend the procedure for BK's but i'm not sure if the advantages out weigh the risks with an AK. I will also say that it depends on what surgeon you have doing the procedure too. Someone else on this forum has ALOT more info on this procedure and I'll just wait for her to chime in before I say anything else as most my information is 2nd hand.
Title: Re: above knee ertl procedure
Post by: Mitchee on March 02, 2009, 06:52:25 PM
Hi Herb.  I'm a BK Ertl so I can't offer much advice about an AK Ertl.  Hopefully there is an AK Ertl who can answer your questions. 

I haven't heard anything about the myoplasty coming undone in AK Ertl's.  I would definitely mention it to your surgeon.

I'm not sure about the recovery time for an AK Ertl.  A BK Ertl usually takes about 8 weeks to heal.  I tend to heal slowly so I wasn't able to bear any weight and use a prosthesis until 12 weeks post op. 

As a BK Ertl, I would highly recommend the procedure. 

Speaking from my experience as a BK Ertl...
The bone bridge provides a stable platform for weight bearing.  I can bear weight directly on the end of my residual limb without any discomfort or pain.  The bone bridge also provides a closed bone system so that no blood or bone marrow leak into the surrounding tissue.  The myoplasty allows me to flex and contract the muscles in my residual limb.  The myoplasty keeps the muscles from completely atrophying and keeps the blood pumping efficiently in my residual limb.  The blood vessels were individually ligated and the nerve endings were allowed to retract up into the muscles.  I have not had any problems with neuromas or nerve pain.  Lastly, my skin was closed smoothly without any dog ears or any other skin problems. 

I'm sorry that I couldn't answer any of your questions.  Hopefully some of the above info will be of use??

Good luck!! 

Michelle
Title: Re: above knee ertl procedure
Post by: herb on March 02, 2009, 08:26:13 PM
Hi Michelle - thanks for your response. My surgeon does both ak and bk ertl style amps. He speaks highly of the results. He says that most docs do not do the procedure because it keeps them away from the golf course too long. I spoke to one other surgeon who only does the usual chop. He brags that he has done so many that his average time doing an amp is less than 30 minutes. thanks, herb
Title: Re: above knee ertl procedure
Post by: Mitchee on March 03, 2009, 01:39:15 PM
Hi Herb.  Since your surgeon is familiar with the Ertl procedure and recommends it, I would give it some serious thought. 

Michelle
Title: Re: above knee ertl procedure
Post by: Robogirl on March 04, 2009, 04:26:37 PM
Herb,

I'd ask your surgeon how many AK Ertl's he has done as revisions as opposed to first time amputation.  The condition of the skin, tissue, and muscle have a lot to do with the success or failure of the procedure.   I'd also ask to meet or talk with some of his patients who have had an AK Ertl revision and see how happy they are with it long-term (more than a year afterwards). 

I speak for myself and some other AK amputees who have indeed had unsuccessful Ertl revisions (done by the actual "Ertl's").   It CAN come undone as the muscle is very heavy and the attachment does not always hold.  Your doctor may have had a different result and/or a slightly different procedure, but again, I'd urge you to make certain that he has performed several successful AK revisions, and not only first-time amputations before you go forward with it.
Title: Re: above knee ertl procedure
Post by: herb on March 04, 2009, 10:37:20 PM
Hi Robogirl - thanks for your advice. I have heard similar tales elsewhere. I am kind desperate to do something quickly. I have been 6 weeks out of my prosthesis and will be broke if I can't get back to work soon. I had massive trauma to my femur. The muscles are all scar tissue and I have a lot of hardware that they will have to remove also. There will be one additional surgeon just to work on the hardware removal. The muscles will never be functional. They will be attached and will mostly be placed for padding the end of my residual leg. My prosthetist is planning to attend the procedure. I am hopeful that this surgery will end my increasingly frequent and strong pains which the doctors attribute to neuromas. When your muscle came undone, were they able to fix it without a revision? Were you ultimately pleased with your results? thanks, Herb
Title: Re: above knee ertl procedure
Post by: Robogirl on March 05, 2009, 11:13:47 AM
I'll email you with more details, Herb.
Title: Re: above knee ertl procedure
Post by: JClark on March 07, 2009, 10:22:29 AM
Hi Michelle - thanks for your response. My surgeon does both ak and bk ertl style amps. He speaks highly of the results. He says that most docs do not do the procedure because it keeps them away from the golf course too long. I spoke to one other surgeon who only does the usual chop. He brags that he has done so many that his average time doing an amp is less than 30 minutes. thanks, herb

A doc bragging about how quick he can do an amputation?  I got him beat!  I did one in about 5 SECONDS.  Let's see a doctor match that!
Title: Re: above knee ertl procedure
Post by: herb on March 07, 2009, 01:03:27 PM
Hi Jason - you definitely got him beat, but how often can you repeat your feat? Herb
Title: Re: above knee ertl procedure
Post by: JClark on March 07, 2009, 06:57:46 PM
Hi Jason - you definitely got him beat, but how often can you repeat your feat? Herb
Well, I can repeat my feet once more, then I would need a volunteer.
Title: Re: above knee ertl procedure
Post by: naseigfried on March 16, 2009, 09:42:07 AM
Hi Herb:

There are two gals on HM forum who had an AK Ertl. They both came to OKC to see Dr William Ertl. I believe that they are quite happy with their results. Both of them lost their legs to cancer. I think Cheri is a high AK where Karen has a longer stump. I don't know if they are on this forum or not. Come over and I'll introduce you to Karen and Cheri.

Neal
Title: Re: above knee ertl procedure
Post by: herb on March 16, 2009, 03:23:17 PM
Hi Neal - it has been so long since I've looked at the HM site that I have forgotten my username and password. I have gotten feedback from a few people who have had the procedure and who were not entirely happy with it. I have finally gotten over my infection and have mostly healed but still have raw areas. The surgeon thinks I have improved enough that he no longer thinks I need a revision. They are going to do surgery to remove the dog ears on my residual leg that are causing the problems. They are not going to shorten my femur as they originally wanted to do. I am hopeful that will solve my problems and get me back in my prosthesis. thanks, herb
Title: Re: above knee ertl procedure
Post by: Mitchee on April 22, 2009, 12:15:57 PM
Hi Herb,
How is your leg feeling?  Are you able to wear a prosthesis again?  I hope that you are feeling much better.

Michelle
Title: Re: above knee ertl procedure
Post by: herb on April 22, 2009, 12:42:17 PM
Hi Michelle - I am getting closer to being in my prosthesis. I had a revision surgery two weeks ago. Had the stitches taken out yesterday and will be casted for a new socket in a few days. I am very tired of crutches and am eager to be walking again. There was some  bleeding when they cleaned up my incisions yesterday. The incisions are tight and look to be healing well. My prosthetist wants the wounds to be dry by the time I am in a new socket. Thanks, Herb
Title: Re: above knee ertl procedure
Post by: pegleg jack on April 23, 2009, 09:25:14 AM
Herb, glad to hear that your moving on getting up and walking, but please dont push it, just take one day at time, have seen where a person pushed it a tad to fast and instead of going forward they went backwards and where in a wheel chair for a couple of months, dont want to see that happen to you, dont worry about the bleeding for it come from the stitces, every time they take them out on me they get a small amount of blood, it will heal up fast.