Corey Sullivan, BS
Senior Clinical Research Coordinator
Corey Liam Sullivan, BS; Rachael Bellamy Chiao, BS; Sarah Welch, DPT; Tawnee L. Sparling, MD; David Crandell, MD; Matthew J. Carty, MD
Matthew J. Carty, MD
Research Category: Musculoskeletal/Orthopedics/Sports Medicine
A 51-year-old male athlete with a history of a left comminuted closed tibial fracture and posterior knee dislocation after a skateboarding accident presented with complaints of chronic left knee pain and stiffness. Prior treatment included nine surgical interventions and extensive outpatient physical therapy.
Given his functional impairment and pain, the patient elected to undergo a modified trans-femoral agonist-antagonist myoneural interface (AMI) amputation. AMI constructs, comprised of surgically coaptated native muscle dyads, serve as a biomechatronic interface that reflects proprioceptive sensation of a phantom limb onto the central nervous system and prosthetic devices.
Post-operatively, the patient participated in a novel multidisciplinary inpatient/outpatient rehabilitation program at Spaulding Rehabilitation Hospital. By the 12-month follow-up, the patient reported return to a pain-free, active lifestyle. He has been able to achieve his goal of resuming strength & conditioning training and returning to endurance cycling. Clinical outcomes data and patient-reported outcomes measures demonstrated a reduction in limb pain, a mitigation of phantom limb pain, and the preservation of limb proprioception (as measured by phantom limb sensation). PT outcome data demonstrates a significant increase in functionality when compared to pre-operative trials.
This case presents an atypical surgical intervention and subsequent rehabilitation protocol for athletes who lose an extremity to trauma. In this patient, limb salvage had failed to meet his functional goals and his quality of life was decreased. After undergoing a modified amputation with AMI constructs and participating in a structured inpatient/outpatient multidisciplinary rehabilitation program, the patient rapidly returned to near pre-injury baseline. He was able to confidently surpass standard short and long-term PT goals while pursuing his own physical endeavors outside of clinic.