Sunday, July 13, 2008

Biomet Donation Saves a Leg in the Dominican Republic

Multiple surgeons in Santo Domingo had recommended amputation, but when 43 year old Marineris came to CURE International’s hospital she was given a new hope. She had been diagnosed with an advanced giant cell tumor which had completely destroyed the bone just above her knee. In spite of working in an environment of limited resources I very seldom compromise my surgical indications. But in this case I knew it would be difficult to provide state of the art limb salvage reconstruction surgery for this patient whose resources were already exhausted with a few simple preoperative imaging studies.

The first step was to confirm the ambiguous pathology report with Dr. Craig Zuppan at Loma Linda University a ‘virtual missionary’ who gives his time and expertise for people he never meets. Thanks to FedEx and email, one day later, Dr. Zuppan had received the specimen in southern California and confirmed the diagnosis. Lung metastasis were ruled out and with a marginal resection her prognosis would be good. I presented the situation to some of my contacts at Biomet who had helped one of our patients a couple of years ago. Not much hope was initially given due to new government restrictions on any donations that could be construed as physician enticement. After a month long approval process government monitors determined that my practice does not represent any lucrative incentives for corporate donations and Biomet approved the donation. When I announced the news to Marinerys and her husband, tears came to their eyes and hope of living a relatively normal life was restored.

Multiple emails were exchanged with Mark Bollinger and Troy Hershberger of Biomet, Warsaw, IN. Final preoperative planning was wrapped up with a meeting at Starbucks Santa Monica, CA between myself and Tyler Jolley the Los Angeles Biomet limb salvage specialist. I returned from my trip to California loaded with instruments and implants.

After maximal preparation and a prayer… the operation was initiated. The absence of a vascular surgeon, vessel clips and a Biomet rep added to the difficulty of the case. But after 3 hours of surgery the tumor was resected and the prosthetic reconstruction begun. The innovative Biomet Compress prosthesis addresses the problem of loosening at the implant bone interface by loading the bone with up to 800 lbs of continuous spring loaded force to invoke an incredibly strong biologic bond between the metal and bone. We released the spring loaded force and placed the $20,000 implant without difficulty. Her recuperation phase was begun.

It does not matter that Marineris knows nothing about Warsaw, Biomet, Loma Linda, Lemoyne, bone ingrowth, or all the work and resources that multiple people around the world have invested to make this operation a success. She appreciates her leg and her life. Worth more than a insurance reimbursement are the two mangos and a hug that I pass on to all who have given unselfishly to make this possible.