UP team performs SA-first surgery to attach artificial foot to three-year-old Rottweiler

Newswise — PRETORIA - A young Rottweiler has been given a new lease on life following innovative, ground-breaking  prosthetic surgery to make him fully mobile again. Three-year-old Covid is on his way to recovery after  successful surgery that’s allowed the attachment of an artificial foot to give him maximum quality of life.  

It’s a huge feat and boost for the team at the University of Pretoria’s (UP’s) Onderstepoort Veterinary  Academic Hospital, who are celebrating the first known successful intraosseous transcutaneous amputation  prosthesis (ITAP) surgery in South Africa. 

And it seems the recipient of this pioneering surgery is just as upbeat, and has returned to his playful self. His  relieved owners say he is walking and running with their other dogs at home and does not appear to be in any  pain.

Covid arrived at Onderstepoort – which forms part of UP’s Faculty of Veterinary Science – with a severe and  debilitating injury to his right paw. It was a nerve-wracking time for everyone because the conventional  treatment for such an extensive wound would normally be amputation. In Covid’s case, despite initial hopes  of saving the limb, evidence of compromised blood supply also indicated amputation would be necessary.  

Lead surgeon Dr Klaas-Jan van de Wetering, in discussion with Covid’s owners, knew this would not be the  optimal solution because of challenges faced by large breeds with only one front limb. So they looked for a  solution that would ensure Covid maintained his quality of life. 

After intense discussion and research, a decision in favour of partial amputation was then made. This, in turn,  would make Covid an ideal candidate for intraosseous transcutaneous amputation prosthesis (ITAP) surgery.  

The pioneering surgery involves creating and printing a prosthetic implant that integrates with the amputated  limb, allowing for the attachment of an artificial foot. Simply put, an implant was placed in Covid’s bone and  exited the skin where a prosthetic foot could be attached. But first, the wound was closed for healing. 

While the wound was recovering, the hard work began, and a CT scan was conducted to aid in planning the  implant. Orthopaedics company Orthodesign assisted with the images, which were then used to create a  custom-fitted implant.  

Getting the perfect fit was imperative, so a 3D implant was printed in plastic for evaluation on a printed model  of the limb. After minor adjustments, the final implant was 3D-printed in titanium.  

Once Covid's wound had healed, the implant was inserted in a subsequent operation eight weeks after the  initial surgery. 

Dr Van de Wetering said Covid demonstrated recovery and strength during his hospital stay. “Post-operative  infection was a concern, but fortunately it did not occur. Continuous monitoring for infection is ongoing, and  periodic replacements of the prosthetic foot are performed as needed.” 

But the surgical team has no plans on stopping there. 

“We have replaced Covid’s prosthesis twice in four months, but we are busy designing a more robust one that  would hopefully last longer,” Dr Van de Wetering said. 

He is positive about what the future holds: “The fact that the surgery was a success makes it a possible surgical  treatment for other patients that need amputations but would not cope with an amputation. For instance, a  double amputee and large breed dogs that struggle with only three legs. 

“This case marks the first known successful ITAP surgery in South Africa, showcasing the collaborative efforts  of the surgical team, biomechanical engineer, and support staff. The groundbreaking procedure not only saved  Covid's limb but also provided valuable insights into the feasibility and success of ITAP surgery in veterinary  medicine.” 

The success of the surgery was made possible by the dedicated efforts of the surgical team. Dr Van de Wetering planned and performed the surgeries with the assistance of his Faculty of Veterinary Science colleagues Dr  Elge Bester and Dr Adriaan Kitshoff, as well as the expertise of biomechanical engineer Tim Peach from  Orthodesign. Theatre nurse Adele Rossouw and anaesthetist Justin Grace also contributed their skills.