First Combat Veteran to Undergo Osseointegration Surgery at Portland VA Medical Center is Now in the Early Phases of Walking
Amputee Veterans are taking back their physical independence thanks to advances in amputation reconstruction surgery available in the VA Portland Health Care System.
“A journey of a thousand miles begins with a single step.” -Lao Tzu
Any form of amputation can be a life changing experience that can affect a person’s independence – hindering their ability to move, work, and possibly interact with others. Thanks to a protheses implant system now available with the VA Portland Health Care System, one retired Combat Veteran impacted by amputations is already taking his independence back.
On August 31, 2012, near Kandahar, Afghanistan, then U.S. Army Sergeant First Class Wade Mitcheltree was severely injured after stepping on an improvised explosive device (IED). The injuries he sustained caused the loss of his right leg above the knee, his right arm below the elbow, pelvis fracture, eardrum rupture, and severe left leg injuries which eventually led to amputation below the knee on that side.
The use of socket protheses helped Wade regain mobility, but his years sitting on the hard above-knee prosthetic socket in his right leg would pitch him to the side when seated, resulting in lower back pain and other discomforts due to the asymmetry in his posture. It was clear that better options were needed.
In early 2022, Portland Amputation Clinic Medical Director Dr. Stephanie Liu began working to bring the Osseo-anchored Prostheses for Rehabilitation of Amputees Implant System, (OPRA) to Portland. Site approval was acquired in 2023 and today medical staff celebrates the significant strides Wade makes as the first Veteran to undergo Osseointegration (OI) surgery and continues to find more comfort and control in his ability to stand upright and walk on his own. He has one leg with a below-knee socket and the other with a transfemoral (above-the-knee) OI prosthesis.
“His determination to walk is a testament to his resilience and the exceptional care provided by our Physical Medicine and Rehabilitation (PM&R) team,” said Dr. Hadi 'Lucas' Anissian, Orthopedic Surgeon with the VA Portland Health Care System. “I feel incredibly blessed and honored to work alongside such talented and dedicated professionals who are now able to offer a procedure which makes a profound difference in our patients’ lives.”
Dr. Anissian, who was the lead surgeon for Wade’s OI surgery, was familiar with the concept and surgical procedure long before the device was approved for use by the FDA in 2020. That familiarity prompted conversations with Dr. Liu to discuss collaborating on bringing this treatment option to the Portland VA Healthcare System. He says bringing this new surgical technique and treatment option to the Portland region is not just a professional accomplishment, it is “A genuine commitment to enhancing the lives of our Veteran amputees. With the fast-moving AI and advancements in intelligent limb prosthetic devices, osseointegration surgery opens doors to possibilities and improvements that were unimaginable just a few years ago.”
The VA Portland Health Care System is the second VA in the nation to perform OI surgeries for above-knee amputees. The Center’s OI team includes two Orthopedic surgeons, Dr. Hadi ‘Lucas’ Anissian and Dr. Kenneth Gundle, rehabilitation from Physiatrist Dr. Stephanie Liu, Physical Therapist Hannah Burkhart, and VA Certified Prosthetist/Orthotist (CPO) Sophy Puth, and Puget Sound VA Regional Amputation Medical Director Dr. Rebecca Speckman. They receive additional support through the VA National Amputation System of Care.
Why Would Someone Need the OPRA Implant System?
The OPRA Implant System is designed for adults who have transfemoral—or above-the-knee—amputations who may also have rehabilitation problems with a conventional socket prosthesis, or in some cases cannot use them at all. Issues with a traditional prothesis can lead to many people being wheelchair-bound or less functional and/or comfortable than they could be.
Other issues that may arise include:
- Impaired biomechanics (natural movement)
- Personal inconveniences due to time required to put on/take off the prosthesis (needing to use the bathroom at night, emergencies, etc.)
- Chronic discomfort when sitting or standing
- Fit challenges/socket falling off which can result in social embarrassment, or worse, falls
How the OPRA Implant System Works
Seven components are implanted during a two-stage surgery which allows direct attachment of prosthetic components to the femur.
- Stage One: Fixture is implanted into the femur; then a central screw is inserted into the fixture. Estimated recovery time: Three-to-six-months.
- Stage Two: An abutment* is attached to the fixture which extends outside the skin for external prosthetic attachments. Then an abutment screw is attached to lock fixture and abutment together. Estimated recovery time: Six months.
* Abutments are connecting pieces that join a prosthesis to an implant.
Positive Results and a Positive Attitude
During Wade’s most recent follow-up visit, doctors confirmed he continues to experience normal healing without infection or other complications at the surgical site and that he has made remarkable progress in his weight-bearing and walking training programs.
If there is anything other than excellent medical assistance that can be attributed to Wade’s recovery and progression it is by far his infectious positive attitude. A father to two sons and sweet service dog, Wade’s “loving dad” personality unsurprisingly extends beyond family as volunteers his time speaking to children at local Ronald McDonald homes, which provide access to medical care, a home away from home, and a community of support for seriously ill or injured children and their families. “I remember the first time I talked to a young lady who had lost both her hands and feet. She was still very self-conscious about her situation to where she kept herself covered up under four blankets to hide her arms and legs,” Wade said. “Well, I was the first person she had met with amputations as well, and over time I helped her learn that yes this is unfortunate, but you know what? You can still get your life back. Now she’s back at home and doing good, making progress with her arms and legs and being very active.”
Wade strongly believes it is important for others experiencing life-changing injuries to never let that make them feel ‘less than.’ “You can still do anything and everything that everybody else does, you’re just going to do it a different way,” he said. When asked if at this point in the recovery process with his new implant if he would elect to do it all over again, he said without hesitation, “Absolutely, yes!”