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Wayne Moorehead who is a quadruple amputee is going through the process of healing from a osseointegrated prosthetic limb implant surgery. The option makes life easier for above-the-knee amputees who have problems with their prosthetics. Moorehead met up with his doctor to take a look at the healing wound and to remove the stitches, Tuesday, May 3, 2022, in Houston.

Wayne Moorehead who is a quadruple amputee, talks to a member of the medical staff during an office visit, Tuesday, May 3, 2022, in Houston. In 2018, Moorehead, got sick and developed sepsis. To save his life amputations were made.

Wayne Moorehead who is a quadruple amputee is going through the process of healing from a osseointegrated prosthetic limb implant surgery. The option makes life easier for above-the-knee amputees who have problems with their prosthetics. Moorehead met up with his doctor to take a look at the healing wound and to remove the stitches, Tuesday, May 3, 2022, in Houston.

Wayne Moorehead who is a quadruple amputee is going through the process of healing from a osseointegrated prosthetic limb implant surgery. The option makes life easier for above-the-knee amputees who have problems with their prosthetics. Moorehead met up with his doctor to take a look at the healing wound and to remove the stitches, Tuesday, May 3, 2022, in Houston.

Wayne Moorehead who is a quadruple amputee is going through the process of healing from a osseointegrated prosthetic limb implant surgery. The option makes life easier for above-the-knee amputees who have problems with their prosthetics. Moorehead met up with his doctor to take a look at the healing wound and to remove the stitches, Tuesday, May 3, 2022, in Houston.

Memorial Hermann orthopedic surgeon David Doherty places clean bandages on the area where Wayne Moorehead’s osseointegrated prosthetic limb implant surgery took place. Moorehead is a quadruple amputee going through the process of healing from the surgery. The osseointegrated implant makes life easier for above-the-knee amputees who have problems with their prosthetics. Moorehead met up with his doctor to take a look at the healing wound and to remove the stitches, Tuesday, May 3, 2022, in Houston.

Memorial Hermann orthopedic surgeon David Doherty places clean bandages on the area where Wayne Moorehead’s osseointegrated prosthetic limb implant surgery took place. Moorehead is a quadruple amputee going through the process of healing from the surgery. The osseointegrated implant makes life easier for above-the-knee amputees who have problems with their prosthetics. Moorehead met up with his doctor to take a look at the healing wound and to remove the stitches, Tuesday, May 3, 2022, in Houston.

Memorial Hermann orthopedic surgeon David Doherty removes the clips from the surgery wound on Wayne Moorehead’s osseointegrated prosthetic limb implant. Moorehead is a quadruple amputee going through the process of healing from the surgery. The osseointegrated implant makes life easier for above-the-knee amputees who have problems with their prosthetics. Moorehead met up with his doctor to take a look at the healing wound and to remove the stitches, Tuesday, May 3, 2022, in Houston.

Memorial Hermann orthopedic surgeon David Doherty places surgical tape on the surgery wound of Wayne Moorehead’s osseointegrated prosthetic limb implant. Moorehead is a quadruple amputee going through the process of healing from the surgery. The osseointegrated implant makes life easier for above-the-knee amputees who have problems with their prosthetics. Moorehead met up with his doctor to take a look at the healing wound and to remove the stitches, Tuesday, May 3, 2022, in Houston.

Memorial Hermann orthopedic surgeon David Doherty places surgical tape on the surgery wound of Wayne Moorehead’s osseointegrated prosthetic limb implant. Moorehead is a quadruple amputee going through the process of healing from the surgery. The osseointegrated implant makes life easier for above-the-knee amputees who have problems with their prosthetics. Moorehead met up with his doctor to take a look at the healing wound and to remove the stitches, Tuesday, May 3, 2022, in Houston.

Memorial Hermann orthopedic surgeon David Doherty talks to Wayne Moorehead, quadruple amputee who recently went through osseointegrated prosthetic limb implant surgery. The osseointegrated implant makes life easier for above-the-knee amputees who have problems with their prosthetics. Moorehead met up with his doctor to take a look at the healing wound and to remove the stitches, Tuesday, May 3, 2022, in Houston.

Memorial Hermann orthopedic surgeon David Doherty talks to Wayne Moorehead, quadruple amputee who recently went through osseointegrated prosthetic limb implant surgery. The osseointegrated implant makes life easier for above-the-knee amputees who have problems with their prosthetics. Moorehead met up with his doctor to take a look at the healing wound and to remove the stitches, Tuesday, May 3, 2022, in Houston.

Memorial Hermann orthopedic surgeon David Doherty fist bumps his patient Wayne Moorehead, a quadruple amputee who recently went through osseointegrated prosthetic limb implant surgery. The osseointegrated implant makes life easier for above-the-knee amputees who have problems with their prosthetics. Moorehead met up with his doctor to take a look at the healing wound and to remove the stitches, Tuesday, May 3, 2022, in Houston.

Memorial Hermann orthopedic surgeon David Doherty fist bumps his patient Wayne Moorehead, a quadruple amputee who recently went through osseointegrated prosthetic limb implant surgery. The osseointegrated implant makes life easier for above-the-knee amputees who have problems with their prosthetics. Moorehead met up with his doctor to take a look at the healing wound and to remove the stitches, Tuesday, May 3, 2022, in Houston.

Memorial Hermann orthopedic surgeon David Doherty takes a photo of his patient Wayne Moorehead who recently went through a osseointegrated prosthetic limb implant surgery. Moorehead is a quadruple amputee going through the process of healing from the surgery. The osseointegrated implant makes life easier for above-the-knee amputees who have problems with their prosthetics. Moorehead met up with his doctor to take a look at the healing wound and to remove the stitches, Tuesday, May 3, 2022, in Houston.

A bout with sepsis nearly killed Wayne Moorehead. Four amputations and six years later, he’s ready to find a new way to walk again.

Moorehead first suspected food poisoning from dinner the night before in July 2018. When he told his wife, Barbara Moorehead, that he would call in sick, she insisted on heading to a doctor.

By the time he arrived at the clinic near his home in Alexandria, La., he was already beginning to turn blue.

“They did a CT scan, but they couldn’t find out what was wrong,” he said.

He was sent him home with anti-nausea medication, but his condition worsened. That evening he was in the emergency room. Soon after being admitted, Moorehead went into septic shock, a life-threatening infection that explained his low blood pressure.

Moorehead was transported to a hospital in New Orleans, where doctors continued to search for the cause. All the while, his hands and feet were no longer getting the blood supply they needed, which would continue for weeks.

When doctors could not diagnose Moorehead, they suggested he return to Alexandria, but his wife and their daughter, Christmas Day LeBlanc, were determined to find another option.

“The best hospital we could find, that’s what we were looking for,” Moorehead said. “We ended up going to Houston Methodist.”

That’s where the root cause of his sepsis was identified: a strep infection of the heart.

By then, however, it was too late to save his limbs. Five weeks had passed since symptoms started.

Moorehead, now 52, underwent two surgeries to remove his arms and legs in September 2018. His amputations were above the knee and above his elbow.

“They were dead,” he explained. “And I knew they weren’t coming back. I needed to get going and get started with my new normal.”

Moorehead received prosthetic devices for his arms that helped, and his recovery journey was well underway at TIRR Memorial Hermann.

There was just one problem.

The socket prosthetics for his legs weren’t working. Simply putting the heavy prosthetics on was also a challenge. Once on, the sockets were hot and would pinch his skin and muscles.

“It’s difficult for me to walk in the sockets,” he said.

Moorehead describes his gait as more like a waddle. The devices weigh about 12 pounds each, which he has to lift with the remaining part of his leg.

“It’s like pushing a car, once you get it going, it’s not easy to stop,” Moorehead said. “I would crash a lot and then fall.”

More often than not, he decided to stick with his wheelchair instead of bothering with the sockets.

Then he discovered two things that would change his outlook. The first was osseointegration, a procedure that grafts a metal rod into the bone, which extends out of the skin. A prosthetic device then snaps directly onto the metal.

The second was Memorial Hermann’s orthopedic surgeon Dr. David Doherty, who also serves as assistant professor of orthopedics at UTHealth’s McGovern Medical School.

“He’s the only one in the region doing osseointegration,” Moorehead said.

And Doherty was right there in Houston, where Moorehead was already in therapy.

The earliest archaeological evidence of a prosthetic device is a toe, found in Egypt in the tomb of a mummy, dating between 950-710 B.C. There are even earlier references to prostheses in Indian texts from 1400 B.C.

There are paintings and records about prosthetics in ancient Greece, Doherty said.

“Fast-forward a couple of thousands of years, and there have been amazing advances in prosthetics,” he said. “But the way we attach them is the same. And it’s clearly the weak link in the whole system.”

Socket prosthetics, which attach to the remaining limb stump with a fitted socket, have long been the standard.

Often, they work just fine, but it’s trickier when an amputation is above the knee, where there is more tissue to fit into the socket, Doherty said. And that can result in chafing, blisters and falling.

Because the soft tissues are enveloped inside the socket, bones can lose their support and adopt an abnormal position, he said. This can lead to loss of muscle function and balance. In the long run, patients can face chronic pain in the leg, hip or lower back, as well as joint arthritis and degeneration.

“It’s like wearing a very poor-fitting shoe,” Doherty said.

In fact, he said that about 75 percent of above-the-knee amputee patients have significant issues with the traditional socket prosthetic. “It can rub a wound on them, which can get infected,” he said. Redness, friction and pain often result.

The procedure’s origins can be traced to 1969 with Dr. Per-Ingvar Brånemark, a Swedish professor at the Institute of Applied Biotechnology, University of Goteborg. He discovered that living bones could connect with titanium rods.

Since then, the concept has been used in knee and hip replacements, as well as dental work.

Rickard Brånemark continued looking into his father’s research and applied it to amputees in the 1990s.

Osseointegration has since become an option for prosthetic surgery in Europe and Australia.

Doherty learned about osseointegration in 2017 and said he was immediately intrigued. He went to Sydney, Australia, for three months to observe Dr. Munjed Al Muderis in surgery.

The two went to Baghdad to treat Iraqi soldiers who lost their limbs fighting ISIS.

A year after he returned to Texas to start practicing medicine, the Food and Drug Administration approved osseointegration in 2020.

Doherty was eager to incorporate the technique in the treatments he offered patients, becoming the first in the region and in Texas.

Currently, only two sites in Texas — and just a handful in the nation — perform osseointegration.

Osseointegration requires two separate procedures — one surgery implants a metal rod into the bone, almost like a large screw, and the second creates a hole, or stoma, where the metal can protrude.

In between the two operations, the patient’s bone grafts to the titanium rod. Three months is reserved between surgeries for the initial connection, allowing it to become mature enough to begin bearing weight, Doherty said.

After the second procedure, patients heal for about a month before they begin physical therapy. Eventually, they can then simply snap the prosthetic leg onto the piece of metal in their leg.

“It locks into the device, which is already implanted,” Doherty said.

Curtis Kindred, a resident of Deer Park, underwent his second surgery about a year ago.

His amputation was in September 2017, after an injury at work, and he started using a socket prosthetic the following year.

Because he often works outdoors as a safety coordinator, it’s not uncommon that the socket will start to slip off, due to the heat and sweat.

That’s why Kindred was interested in osseointegration when he learned about the option. He scheduled his first surgery in February 2021, soon after the FDA approval.

“They open up your leg and have to start with a clean slate,” he said. “Then they drill into your femur.”

For the next couple of months, Kindred was in a wheelchair. Then, he returned for his second surgery in May 2021. After two more months, he began one-hour sessions of weight-bearing exercises each day.

He would position a chair next to a scale and start placing up to 10 pounds of his weight on the prosthetic leg. After a week, he went up to 20 pounds, then moved up to 50 pounds.

“Once you get up to full weight, you’re able to put on your leg,” Kindred said.

Using the socket did not require the same strength, and he said he’s is still in the process of building back his muscles.

Already, osseointegration has helped him better navigate the job site.

“I don’t have to worry about my leg slipping out,” Kindred said. “I don’t have chafing, redness or soreness. And getting ready now only takes two minutes instead of 15.”

The method is not for everyone, he said. Other amputees may not want to undergo surgery again or have the protruding metal rod and stoma that the process requires.

For Kindred, however, it was well worth it.

“I would absolutely recommend it,” he said. “I was just tired of dealing with the pain all of the time. It was always a burden, taking the leg on and off. Now, all I have to do is pick up my leg, pop it on and go.”

Osseointegration is currently approved by the FDA only for above-the-knee amputations. Doherty said that the process would also be ideal for above the elbow and thumb prosthetics in the future.

“As we do more and more of these, it will give us the opportunity to study it more extensively and find techniques to optimize the surgery,” he said.

Currently, candidates are often war veterans or those who have suffered a traumatic injury to their legs, Doherty said. Patients who have amputations after being treated for tumors or bone cancers can also use this method.

Because the bone grafts to the metal attaching to the prosthetic, the patient has more of a sense of feeling while walking called “osseoperception.” For instance, patients can tell what kind of surface they are walking on — or if they step on a rock, Doherty said.

“It’s a similar concept to a cochlear implant,” he said. “The same kind of thing happens. Your perception changes.”

Patients also have a better sense of balance, he added. With the socket, amputees have to constantly concentrate on the ground.

“With this, their eyes come up,” Doherty said. “They watch the world again. It helps them enjoy walking more.”

Often, his patients have been in wheelchairs for years before osseointegration.

“It’s often the first time in years that they have walked,” Doherty said. “It’s one of the most rewarding things I’ve ever been a part of — watching this transformation occur.”

Doherty said the revolutionary procedure puts us on the cusp of achieving things that once only seemed like fiction. The prosthesis literally becomes an extension of the skeleton. Think Bionic Man or Terminator.

“It’s really the forefront, the cutting edge,” Doherty said. “We’re getting to participate in something patients can’t find anywhere else. And even just a few years ago, we weren’t ready to do this.”

Doherty has performed 10 osseointegration surgeries so far.

Moorehead is the second bilateral amputee on the list. His first surgery was completed in early January, and the second was in April. He is looking forward to starting physical therapy at TIRR again.

“I’m ready,” Moorehead said.

The 30 minutes it used to take to put on the socket prosthetics will be reduced to about two minutes with the new system.

“It will be a lot more incentive to get up and move around,” he said. “I will just feel better.”

He broke into a grin imagining the possibilities.

“This is Wayne 2.0,” he said. “It’s a new me. We’re doing things, and we’re going places.”

Peyton is a Houston-based freelance writer.

Lindsay Peyton is ReNew Houston's Transformation columnist.

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