Dan Hess is 16, active and growing. Which wouldn't be a problem, except doctors replaced a significant portion of his right leg with a prosthesis five years ago when he had bone cancer. His right leg is already 4.5 centimeters shorter than the left, despite the fact that he's already undergone a lengthening surgery.
Monday morning, Dr. Steven Scott performed what will hopefully be the Viewmont High School junior's last surgery for a long time. Scott replaced the old prosthetic "bone" with one made of polybicarbonate. The new prosthesis is designed to "grow" using a simple half-minute procedure in the doctor's office.
Called a "Repiphysis" device and produced in the United States by Wright Medical Technology Co., it has a strong, coiled spring that's compressed. When it's time to "grow," he'll put his leg in what looks like the center of a large metal ring and Scott will simply push a button. The ring is actually a magnet that releases the locking mechanism in the Repiphysis. The spring unwinds a bit, lengthening the leg. Then it's relocked, and he will go home. It takes 20 to 30 seconds, Scott said.
It's the first time the device has been used in Utah.
It was invented in France, where more than 150 children have had the device implanted. It's not approved yet in the United States, though the FDA has allowed doctors in seven medical centers to use the device about 40 times under its "compassionate use" guidelines. Full approval is expected in the next year or so.
But Hess was growing fast and had probably two or more lengthening surgeries to look forward to when his parents, Paul and Martha Hess of Farmington, asked if there was anything new on the horizon. Scott looked into Repiphysis, which he'd been watching for some time, and suggested the Hesses consider it.
Initially, the device costs about 30 percent more than a standard implant used in the leg. But if it allows Hess to skip even one lengthening surgery, it will more than make that up, Scott said.
No prosthetic bone is as good as the bone nature provided. A section of his femur, all his knee except the knee cap and part of the tibia were removed, then the prosthesis was cemented on, running inside the remaining lengths of bone.
"We say it's a walking, swimming, biking, golfing knee," said Scott, "rather than a basketball knee." Jumping and running can, over time, break it loose.
Since golf's one of Hess' passions, he's not objecting. And when he was diagnosed with osteosarcoma at 11, he thought he was going to die. After the bone was removed, he had chemotherapy and has been in remission ever since. That, coupled with the new, surgery-skipping device, seem pretty good to him.
Repiphysis will likely not be a permanent implant. The plan is that once he has finished growing, doctors will implant a permanent, more durable prosthesis. The material in the Repiphysis isn't as robust as a 1.5-inch titanium bar.
Scott planned to give Hess 2 centimeters of increased length Monday. He'll be on crutches for a couple of weeks, then begin to get his motion back. In a month or so he'll come in to have the device lengthened. Then he'll do that every few months. Because it's so simple, it can be done more often to create smaller increments of growth.
Dan Hess was calm, even smiling, as he went into surgery. "I feel pretty special," he said. "Pretty lucky to live in this age."
E-MAIL: lois@desnews.com