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Carol, has your revision been successful?

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Austin, could you please point me to the web site where yu saw preliminary results for the Ertl amputation study the V.A. is running? I've been very interested in this study and haven't even seen the inclusion protocols, much less any data. Kind of unusual to have anything published before the fully analysis has been completed, which I thought wasn't supposed to be until next year. Thak you!

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Here's a page concerning the new ertl study (Jan 2006 - December 2008):

http://www.ertlreconstruction.com/documents/161.html

They say they're getting early results back, but they don't present any actual results.

Here's the 138 of 143 I remember:

http://www.biomech.com/db_area/archives/20...mp;P3.bio.shtml

In a paper presented in 1997 to the American Academy of Orthopedic Surgeons, Ertl assessed 143 patients who had undergone the transtibial procedure. The long-term results were evaluated with a 30-point clinical score that assessed pain, function, stability, swelling of the residual limb, hours of prosthetic wear, and synostosis of the limb apparent in radiographs. Each symptom was graded on a 1 to 5 scale. The results indicated that 138 patients were rated as good or excellent (20 to 30 points), eight as fair (15 to 19 points) and four as poor (fewer than 15 points). The poor results were in vascular amputees who reported persistent residual extremity pain, but also reported improvement in other parameters, Ertl said.

Here's a document detailing the ertl procedure and the 1980-1995 study (presented in 1997):

http://www.ertlreconstruction.com/documents/108.html

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Thanks, Austin, for those references. I had seen them before and thought it was likely they were the ones you were referring to. Note that the 1997 presentation give by Dr. Ertl does not refer to the current ongoing V.A. study--as far as I know, no data from this study have been released. The 1997 results Dr. Ertl presented point out the problem the Ertls have--they show good results with the Ertl procedure but offer no formal comparisons with other techniques. In other words, what would the results have been like if a similar group of patients had competent surgery of another type? You look at the Ertl results and say, "Compared to what?" Plus, the results in the 1997 presentation appear to have never been published in a peer-reviewed journal. That's what I believe (I hope!) the V.A. study will attempt to do, objectively review techniques and patients, and why it's so important.

Don't get me wrong, I'm really not anti-Ertl. There's no question many who have the procedure get very good results, and I don't want to discourage you from having it done. Like I said before, it really might be better, especially for very athletic amputees. But I do worry about the personal endorsements and enthusiastic reports that may border on hype. I'd like to see some objective evaluations that make it clear this is really a superior technique. Although I know that such studies are really hard, I'm bothered by their absence over more than 80 years. If the Ertl technique is a LOT better, it should be provable. Or, maybe I'm just thiking too much like an isurance company!

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Thanks, Austin, for those references. I had seen them before and thought it was likely they were the ones you were referring to. Note that the 1997 presentation give by Dr. Ertl does not refer to the current ongoing V.A. study--as far as I know, no data from this study have been released. The 1997 results Dr. Ertl presented point out the problem the Ertls have--they show good results with the Ertl procedure but offer no formal comparisons with other techniques. In other words, what would the results have been like if a similar group of patients had competent surgery of another type? You look at the Ertl results and say, "Compared to what?" Plus, the results in the 1997 presentation appear to have never been published in a peer-reviewed journal. That's what I believe (I hope!) the V.A. study will attempt to do, objectively review techniques and patients, and why it's so important.

Don't get me wrong, I'm really not anti-Ertl. There's no question many who have the procedure get very good results, and I don't want to discourage you from having it done. Like I said before, it really might be better, especially for very athletic amputees. But I do worry about the personal endorsements and enthusiastic reports that may border on hype. I'd like to see some objective evaluations that make it clear this is really a superior technique. Although I know that such studies are really hard, I'm bothered by their absence over more than 80 years. If the Ertl technique is a LOT better, it should be provable. Or, maybe I'm just thiking too much like an isurance company!

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Thanks, Austin, for those references. I had seen them before and thought it was likely they were the ones you were referring to. Note that the 1997 presentation give by Dr. Ertl does not refer to the current ongoing V.A. study--as far as I know, no data from this study have been released. The 1997 results Dr. Ertl presented point out the problem the Ertls have--they show good results with the Ertl procedure but offer no formal comparisons with other techniques. In other words, what would the results have been like if a similar group of patients had competent surgery of another type? You look at the Ertl results and say, "Compared to what?" Plus, the results in the 1997 presentation appear to have never been published in a peer-reviewed journal. That's what I believe (I hope!) the V.A. study will attempt to do, objectively review techniques and patients, and why it's so important.

Don't get me wrong, I'm really not anti-Ertl. There's no question many who have the procedure get very good results, and I don't want to discourage you from having it done. Like I said before, it really might be better, especially for very athletic amputees. But I do worry about the personal endorsements and enthusiastic reports that may border on hype. I'd like to see some objective evaluations that make it clear this is really a superior technique. Although I know that such studies are really hard, I'm bothered by their absence over more than 80 years. If the Ertl technique is a LOT better, it should be provable. Or, maybe I'm just thiking too much like an isurance company!

Whoops!! It helps to add something if I 'm going to quote. I pushed the wrong button.

ANYWAY....... I completely agree. I would like someone to explain what is so special about the Ertl procedure/technique. My amputation was done by a Dr. Nichols in Ventura, California, 19 years ago in June, and although I have had 44 total operations - mostly regarding my initial amputation - none have been for the amputation itself, or the immediate revision to set the length of the stump.

After going on 2 years on this forum, I have heard so many complaints and problems that I have never experienced. From a results standpoint, I would say that my doctor and his technique, was as good as they come. All of my subsequent problems, lay with infections and circulatory matters, from other operations.

Also, while I'm on it, I keep hearing about this foot or that foot, and this leg or that leg. I wear, what many describe as the basic. A suprcondulyr suspension, with an Ohio Willow Wood, Carbon Copy II foot, bolted straight on the leg, without any "harware" (ankle, piston, etc.). I climb ladders, walk on roofs, dance, run, bend, kneel, and everything I did before, without all of the fancy equipment. (That is, I did before my circulation returned to the same level it was before they went in to "fix" it.) At night, I slip into it in the dark, like a pair of slippers, and walk around the house "barefoot", and then back to bed and slip it off. No fuss or extra crutches or anything. I just slip my leg back on and go.

How can it be any better than that? My leg fits perfect, without any sores or discomforts. I nap in it, or drive for hours on end, and otherwise, really don't think about it much.

I think that I need to start a campaign for my doctor and my prosthetist. They might solve many of peoples problems.

NOW........ I am being a little facetious because I do know that what works for me, won't work for everyone. I just wanted to make the point that any one procedure - whether it be Ertl or my Dr. Nichols in California, is not the end of all ends.

Shop around, and don't expect miracles from anyone. To me, it is sometimes just a miracle to keep us alive, let alone get our remaining leg back in working order again. You may find your answer right next door to you, (so-to-speak). But definitely, talk to other amputees and listen to them.

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Jim,

I hope to have the kind of easy going, great fit that you have.

My amputation was done ... 19 years ago ... I have had 44 total operations - mostly regarding my initial amputation ...

Wow... no offense, but I really hope I have better luck than that. I'm tired of surgery - you must be also. Looks like you've had about 2 per year, which has been my rate for the past few years.

What I'm really hoping for (and what the ERTL seems most likely to provide) is to have ONE more surgery on this leg. I don't want to be in and out of surgery for the next 20 years. I just want to do it, get it done, and move on.

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No offense taken Austin. I'm alive. That's what counts.

Actually, they went like this

1982 1

1987 5

1988 10 (Year of Amputation)

1991 3

1994 1

1995 15

1996 1

2004 5

2005 1

2007 2

Pulmonary Edema - Infections - Kidney removal - Gall Bladder removal - Repair of 9 hernias,(since, come loose), and a couple of heart attacks that don't count as surgeries - just to name a few. I've also been given up for dead 6 times. (One doctor sent me home with a 105 fever to die. I asked him why he didn't operate and take the infection out and he said that I only had 5% chance. I said "take it". He then said: "I don't want you dying on my table. At home, my family and I picked out my tombstone and I kissed them all goodbye and went to bed. The next morning I woke up soaking wet and they got me to the University Hospital, where they said that it was still 5% but they would take it. They "fixed" me okay. They "accidently" tore the tube, (Uretha) from my kidney to my bladder, and then told me that they couldn't fix it and removed my kidney. I still think that someone is walking around with my kidney. I wish they would have asked. BUT, maybe I'm just being paranoid.

In between all of this, my wife and I lost our home and business, lived in a camping trailer for a year, moved half way across the states (California to Missouri), bought and totally remodeled a little farm house.

Up until the time of my first operation, (Except for the one in 1982), I rarely took even an aspirin a year. Up until 52 years old, I was (am still am), disgustingly healthy. I just had my arteries clog up and asked them to "fix" them. Oh Yeah.

I started to write the story on all of this in 1991 when I only had 14 operations. I am thinking about finishing now that I've gone back and done some more research. :lol: I've got some people that want me to publish it. Who knows. Sometimes it gets a little emotional to remember all of this. You know what I mean.

NO, 2 a year, doesn't quite do it justice - but thanks anyway. :D

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Austin -- this is what a friend of mine had to say about her ERTL, it's along the lines of what you and I are both hoping it can/will do.

---------------------------------------------------------------------------------------------------------------------------

Well it's been 3 months since I've written anything. All is well, my leg is totally awesome! Well half a leg anyways. I never use crutches, I just keep this bad girl on and keep rocking. Considering I had a rough first month post-op I just kept waiting for this time and it's finally here. Actually I went back to work 3 months after surgery. If I have pants on no one even knows I'm sporting a killer prosthetic underneath it all. But hey, it's summer and I wear shorts every day. People are totally cool about it and are totally amazed. I'm not running yet, but I do just about everything I did before. It's all down hill from here.

I have to post some new pics soon. My ERTL IS THE BEST, EVEN OTHER SURGEONS ARE BLOWN AWAY AT MY PROGRESS. OOPS CAPS. The leg has not helped with my lamr typing skills.LOL. Being pain free is such a sense of freedom. So to all of you new amps or soon to be amps, it's all good. Please feel free to ask me anything. I'll do my best to give you good information without the "you should" BS.

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UPDATE ---

I have the go ahead from my lawyer to proceed with amputation and he will be trying to procure Jan Ertl as the surgen to do it. I saw my ortho today and he said "he as done Ertl's before but only when patients have asked for them and researched them on the web". My ortho is ready to roll and wanted me to set a date for the procedure. I'm a little uneasy about how ready and willing my ortho is to do an "Ertl". He's a fabulous surgen and I don't question his skills as a surgen at ALL, but I would feel much better if Jan Ertl does my amputation (hehe go figure). Some of my issues here are time related. Myself and my lawyer both want to move fairly quickly on this amputation in order to get the best care and coverage from the insurance company. So my delema right now is wait and hope that we can get Jan Ertl and if so he has time to fit me in pretty soon, or go with my ortho who really is a very up to date skilled surgen?.

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You're really making progress David. I think you should at least contact Jan Ertl and see what his schedule is (and how well his schedule fits your schedule) before you decide which surgeon to go with.

I know if it were me and I lived almost next door to Jan Ertl, I'd try my hardest to get him as a surgeon.

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