Led by Alexis Dang, MD, staff physician at San Francisco VA Health Care System, the Department of Veterans Affairs (VA) completed the first osseointegration (OI) surgery in its history. The patient, Air Force veteran Doug Mayo, received the Osseoanchored Prostheses for the Rehabilitation of Amputees (OPRA) Implant System; the second-stage surgery is scheduled in a few weeks.
Once restricted by federal law that required the VA to provide prosthetic devices through the use of low-bid contracts with a long approval process, a change to the law later allowed VA to procure prosthetics “without regard to any other provision of law.” That change meant the VA could acquire and provide the best available devices to veterans without worry about cost.
“It’s a little-known fact that puts VA in a position to stay on the forefront of limb-loss technology and provide the best possible options to veterans in need,” said Dang. “We utilized 3D printing at our VA, which is novel, to help prepare and plan for the surgery. The print showed us where we needed to trim the bone and also remove residual cement from prior surgeries.”
“VA healthcare isn’t handcuffed in the ways traditional insurance providers are,” added Adam Jacobsen, CPO, Omaha VA Medical Center. “If it is FDA approved and medically justified, we can get it for the veteran.”
Mayo had an accident during his Air Force tenure that led to knee replacement surgery, but he first opted for care outside the VA system. After 13 surgeries in three years because of failures of the replacement knee, and a subsequent infection, Mayo had a lower-limb amputation.
“Doug is an active guy. If you know him, you know he gets after it in everything he does,” said Jacobsen. “His private-sector prosthetist couldn’t get him the knee he wanted and that brought him to us at VA. We fit him with a traditional socket, but with his activity, and the things he does, he wanted to get away from the restrictions of the traditional socket.”
Mayo lives 90 miles from the nearest VA facility, but was able to conduct most of his initial consults from home with providers in Minneapolis, Omaha, and San Francisco using the VA Video Connect system.
