New techniques help Bay Area doctors repair bones


While the scars aren't pretty, attorney Rick Trecartin is grateful to have a healthy leg at all. During an earlier surgery to correct an arthritic knee, his bone became infected with the dangerous bacteria MRSA.

"So I was very concerned I might lose my leg, might lose my life," Trecartin said.

After several follow-up treatments, the bone was still refusing to heal. Trecartin was eventually referred to Dr. Amir Metityahu with the Orthopedic Trauma Institute at San Francisco General Hospital.

Metityahu's team removed a significant section of bone and then replaced it temporarily with a bacteria killing bone cement, a technique refined in the last few years.

"So we use bone cement, and inside is a high dose of antibiotic that elutes in the area, so a high concentration of anti-biotic gets into the area," Metityahu said.

After killing the bacteria and removing the cement, the leg was left with a gap. But by placing specialized hardware, often guided by computer, Metityahu says surgeons at the institute are now able to close gaps as wide as 12 inches.

"The body is an amazing thing, it will create a membrane that has all the proteins and stem cells you need to grow new bone," Metityahu said.

In extreme cases, doctors will partially sever sections of bone on either side of the gap, slowly pull them together with hardware. Replacement bone grows in behind, eventually creating a bone bridge that joins in the middle.

In Trecartin's case, the procedure was simpler. A small section of bone from another part of his body was transferred into the gap, allowing his tibia to grow new bone around it.

For Trecartin it's been a long process but he believes a full recovery is still within reach.

"My goal is to get back and play handball and be able to carry clubs on a golf course," he said. "Whether Amir will give authorization, I haven't asked yet."

Because of the bone's ability to regenerate, doctors says even long sections of replacement bone can eventually heal without the equivalent of scarring, functioning as normally as the bone they replaced.

Written and produced by Tim Didion

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