Michael Clough is learning to walk again on his new bone-anchored prosthetic, thanks to a fundraising campaign spearheaded by Woundcare4heroes.
In March 2018, the amputee ex-soldier flew to Sydney, Australia, for a metal implant inserted directly into the bone of the remaining part of his leg, replacing an uncomfortable, ill-fitting socket. This pioneering procedure is not available on the NHS.
Just 12 days after surgery, the 36-year-old was taking his first steps on the bone-embedded prosthetic, walking between two handrails to help support his weight. Daily rehabilitation sessions were “tough – like doing 12 rounds with Mike Tyson but amazing to walk again,” said Michael. Each day, he gradually put more weight on the bone-implanted prosthetic.
“It’s fantastic to go from not being able to walk at all when I boarded a plane to Sydney four weeks ago, to easily being able to walk 100 metres across the tarmac to get the plane home. I am still using crutches as I can’t fully weight bear yet because the bone cells need to bond with the implant and that takes time. But after 12 weeks, I should be able to walk unaided.”
The former soldier described the difference it made to his life. “It is a lot more comfortable and stable. If I put on my old leg it would twist and slip. I would have to find a toilet to sort it out. The difference in stability and practicality is huge.”
He also has a greater sense of feel with his new prosthesis. “As the implant goes directly into my hip, you get a lot of signal through the bone. It feels natural. You can feel the floor and that makes it easier to distinguish between my toe and heel when I walk.”
Through osseointegration, a titanium implant is inserted directly into the femur bone. Then an adaptor is attached to the implant which sticks out through the soft tissue and skin. The false leg is clipped onto the adaptor and can easily be removed at night.
Michael severely injured his leg in parachute training while serving with the 2nd Battalion Yorkshire Regiment in 2012. Ironically, he had been serving in Afghanistan and travelled to Cyprus for the training. After three years and 12 rounds of surgery and rehabilitation to save the limb, he had an above-knee amputation because of devastating bone infection, osteomyelitis.
Michael was given a high-tech false leg with a microprocessor-controlled knee by the military but was unable to use it with a conventional socket that sits over the leg stump.
But the veteran suffered from complex regional pain syndrome (CRPS) which means even the slightest touch to his stump caused excruciating pain. Michael experienced such discomfort and problems with the fitting of his socket, he was unable to wear the artificial leg. As a result, he mostly got about on one leg with crutches for support.
“The loose-fitting socket caused rubbing and pressure points, resulting in infected sores over my stump, leading to further surgeries and potential further limb loss,” said Michael who had plastic surgery to repair skin on his stump damaged by infection and to move a neuroma, or collection of nerve tissue, which aggravated pain caused by pressure from the socket.
He added: “I had 12 socket adjustments in the past two years which cost about £8,000 each, a total of £96,000. That’s more than the cost of my osseointegration implant. This surgery really should be available on the NHS.”
Military surgeon, Lt Col Steve Jeffery, based at the Royal Centre for Defence Medicine (RCDM) in Birmingham, has been pivotal to Michael’s surgical care and recommended him for the osseointegration implant.
Claire Stephens, chief executive of Woundcare4heroes, started Michael’s ‘Walk Again Appeal’ to raise £72,000 to pay for the surgery and four-week rehabilitation with support from friends and family. His former regiment made a major contribution and Michael, who since leaving the military has always worked, sold his home to make up the difference.
The surgery was carried out by Sydney-based prosthetic expert, Dr Munjed Al Muderis, who has performed the procedure on more than 250 patients, including four with CRPS, the same condition as Michael, who was aware of the risks.
“This surgery has definitely changed my life and being able to walk will help my career and everything. The knock-on effects are huge.”
Michael’s first contact with Woundcare4heroes came after his amputation in 2015. He had been advised to contact the charity if he had any wound-related problems. Following post-surgical complications, WC4H twice made a rapid referral – within 48 hours - to military trauma experts at the RCDM. This urgency helped to save Michael’s residual limb. Our consultant nurses have also given Michael one-to-one wound care and advice.
“Woundcare4heroes has made a huge difference, providing me with support and reassurance. The charity is just amazing in terms of everything it does for veterans, especially complex wound cases.”