Off painkillers, and walking on equal legs again

“A thirty-year-old man came with his parents, having been operated on at a very well-known institute of India. A rod had been put in his femur about two years back, and since then there was continuous pus discharge. He came to me thinking we’d be able to save his leg — again, someone who had lost all hope, having already been to some of the largest orthopedic institutes in India.

We identified a large segment of femur bone that had necrosed and needed to be removed from the body. We did it in stages. The first step was to remove the nail — the orthopedic implant itself is often what’s holding the infection in place, so that needs to come out first. We debrided the entire bone, placed antibiotic-loaded bone cement using broad-spectrum vancomycin and gentamicin to increase local antibiotic delivery, and applied an external plate so the bone wouldn’t move too much and he could comfortably get around.

The first thing he told me, after almost two years, was that he was off painkillers. Since his first surgery in Banaras, he had been on painkillers daily for nearly two years — and doctors had warned that the painkillers themselves could be harmful to his kidneys, with the family worried about dialysis or kidney damage down the line. But with no other option to manage the pain, he had kept taking them daily. Our first surgery proved to him that once an infection starts to settle, the pain decreases on its own.

Once the infection had settled, the next job was to bring back the length of his leg, which was almost four inches short. We brought Ilizarov back into the picture, and almost four months later, he came to me walking comfortably — without any kind of shoe raise. His mother’s words stayed with me: “We were not even aware that something like this is even possible. We had lost all hope. We were thinking, at least the infection is gone, so we’ll go ahead and get different kinds of shoes made for him.” But now his legs are equal in length.

This is the story of someone who hadn’t lost hope, who was very persistent through the Ilizarov journey, and who religiously followed the distraction process for more than four months — and that persistence is what brought him these results.”