When it comes to our health we often take our feet for granted, but when they’re injured, normal life can quickly get upended. For one Marshall, MN, collaboration of his care team was the key factor in getting back on both his feet.
They may not seem like much, but for Alan Hansen small steps might as well be giant strides. Just a few short months ago, he faced the real possibility of losing his leg altogether.
“I don't know how well I'd have handled that. I've thought about that a lot. I'm glad I have it. I suppose this stuff can go wrong yet, but it'll be easier to accept now if I lose it because I tried everything I could,” said Hansen.
Innovative Option for Ankle Implant
This last ditch option for Alan involved him becoming a pioneer of sorts — his ankle was the first in South Dakota to be replaced and fused with a new 3D printed implant style of surgery.
“The actual technique of doing the implant, it's not that hard. It's a similar approach to putting in total ankle joint placement. We're just cutting out diseased bone and replacing it with a replica of that bone that is custom molded for his anatomy,” said Peter Bellezza, DPM, with Avera Orthopedics. “The cool thing about it is that we can design it any way that we want it to best fit the patient’s needs. You could cut the material if you wanted to resize it during surgery and that's the flexibility that you don't get when you're using a metal implant or rods.”
Alan was a tricky patient because he’d already had a different surgical repair to his ankle — that he unfortunately reinjured during recovery and developed a severe bone infection.
Collaboration on Care
“I work with infectious disease almost on a daily basis. For inpatients in the hospitals, for the outpatients, podiatry and infectious disease are one,” said Dr. Bellezza.
“We work very closely with podiatry. We are the ones taking care of the medical management, the antibiotics for the infection, but they're taking care of the surgical management, which is so important because in adults, bone infections are really hard to treat with antibiotics. So very often it does require a surgical clean out of that infected bone, and then we can come back behind with antibiotics and mop up any infection that's left,” said Jennifer Hsu, MD with Avera Infectious Disease.
After weeks of daily infusions and the infection under control, Dr. Bellezza was able to use Alan’s X-rays and imaging to create a custom fitted implant – made of a special material – that is designed to get stronger as his body heals.
“The way that I designed the implant is, it's kind of like a lattice structure. So there are lots of mini holes (in the implant) that's kind of similar to the anatomy of a regular bone,” said Dr. Bellezza.
“We were always pretty nervous until he read the X-rays and with the first one he says, ‘I think it's starting to work.’ And next week he says, ‘It's working.’ Well naturally you feel better!” laughed Hansen.
“So even on his X-rays today, you can see it growing into the implant. So it's anchoring itself in. Will it completely grow over it? It may not, but as long as it anchors itself to the top and the bottom, it's not going anywhere,” said Dr. Bellezza.
“You know, I never feel it. The only difference is, my ankle is fused. When you walk, your toes bend; mine won't. But I'm not gonna run any races anymore anyhow. So I don't care. I'm just glad to have my foot!” said Hansen.
A Look at the Future of Podiatric Care
This new surgical option is just another example of cutting edge care available to patients like Alan whose attitude and determination have him already looking for the next challenge.
“Before it happened, I said I'd settle just to stumble around the house. Well, I'm doing that and I expect to improve on that,” said Hansen.
“He has an excellent attitude considering all the setbacks that he had. He was always upbeat. We were always educating him on his options, being very transparent with the battles that he had in the future. And he accepted it and we fixed him and now he's walking in his shoe again,” said Dr. Bellezza.
Learn more about orthopedic and podiatric care at Avera
