Alex Weatherford is a walking miracle.
His new mobile lifestyle is due to his extraordinary determination and a revolutionary surgical procedure, Osseointegration (OI). OI is a game-changer that improves quality of life, function, and mobility in individuals who have had an amputation.
In Alex’s case, he had two above the knee leg amputations.
His world changed September 27, 2014. The day began with a casual visit to friends of his wife, Nicola Dundas, M.D. Alex accompanied one of the newly met friends in his two-seater plane for an aerial view of property in San Jacinto County, 60 miles north of Houston.
Their friends lived in a neighborhood with a private airstrip and as the plane approached, it circled the homes to alert the residents and to allow family and friends to see the landing. Within seconds, a boom thundered through the neighborhood.
Nicola and others fanned out to search for the downed plane that had crashed into a grove of trees. Nicola was one of the first to find the wreckage.
Alex has no memory of that day’s traumatic events.
“I was in bad shape from head to toe,” he says. “The pilot was dead. Nicola called 911 and she knew from my injuries I needed to be helicoptered to a hospital.”
Alex was taken by Memorial Hermann Lifeflight to Memorial Hermann Hospital.
“My legs were crushed, my face was smashed, and I lost considerable blood,” says Alex.
To save his life, the decision was ultimately made to amputate his legs above the knees. “I felt better almost immediately after the surgery,” Alex explains, but challenges followed. His kidneys shut down and he was on dialysis for a month.
“It was tough to come to grips with my emotions,” he says. “What kind of person will I be? Am I still me? Those questions haunted me.”
Alex remembers there were continual decisions to be made. “Doctors and nurses were always in my room,” he says. “Thankfully, Nicola understood the medical options and could explain them.”
The next few years, Alex used traditional prosthetics, two carbon fiber shells that fit from the hip to the bottom of his limbs. “When you wear one on each leg, mobility is slow, and you get sweaty. It’s not comfortable.”
In 2015, because of the issues with prosthetics, Alex discovered a wheelchair better suited him. “It was unfair to my wife and kids to have limited mobility. But I had no choice.”
A dream comes true
During his rehabilitation process, Alex struggled to regain his previous function and began looking for something better. One of his physiatrists told Alex about an innovative technique called Osseointegration (OI), that was not available in the U.S. at the time. “It sounded like a dream scenario,” remembers Alex.
Alex’s dream became reality when Memorial Hermann | Rockets Orthopedic Hospital launched the OI program in 2020 with Integrum’s OPRA newly FDA-approved Implant System. The program is led by Dr. David Doherty along with a multidisciplinary team of specialists: Matthew Koepplinger, D.O.; Jim Kellam, M.D.; Kristin Reeves, PT.; Payam Zandiyeh, PhD.; Vinay Vinodia, M.D.; and Ed Berzin, M.D. The program, which was the first in Texas, has grown significantly and now has over a dozen success stories like Alex’s.
Dr. Doherty is Assistant Professor in our Department of Orthopedic Surgery and a specialist in hip and knee replacement surgery and performs complex adult reconstructive procedures including OI.
“I had confidence in Dr. Doherty immediately,” says Alex, “because of his impressive experience and knowledge. This is a world-class team, and we are so fortunate they are in Houston.” Another positive aspect? Nicola was a medical school classmate of Dr. Doherty’s.
Alex’s first OI surgery was in April 2021. His right limb was longer than his left so the limbs had to be evened out. A titanium rod was inserted into the bone of both limbs and a cap was put on. There was a waiting period for the bone to grow into the rod.
In July 2021, Alex had the OI procedure on both legs, with implants anchored in the bones that were attached to a prosthesis. A titanium rod was inserted into both legs, with a nut protruding from each. “The nuts provided the attachment points to directly connect Alex’s prosthetic legs to his skeleton,” explains Dr. Doherty.
These surgeries are performed in a staged fashion. “The first stage is to implant the device and bone graft to allow for the osseo integration process to occur,” says Dr. Doherty. “The second stage is more involved and requires creating plastic surgery flaps and setting them down in a unique fashion so the bone and skin grow together.”
Advantages of OI
There are many advantages of OI that improve Alex’s lifestyle. The attachment is more stable, making joint movement easier and safer. Common prosthetic challenges are gone because there is no need for a socket.
“For amputees, OI is a life-changing surgical technique,” says Dr. Doherty. “With an implant anchored in the bone and directly attached to a prosthesis, there is no need for a prosthetic socket.” The socket is the most challenging part of fitting a prosthesis.
“Osseointegration requires a dedicated patient and that is Alex,” says Dr. Doherty. “He is a healthy, active person who was ready to push his limits to achieve his goal. He was ready to optimize how he uses his prosthetic limbs.”
Alex is the first double amputee in Houston to have this procedure. “I don’t consider myself a role model,” he says, “but if I can be an inspiration to others, I am happy to be that.”
A few months after the surgery, physical therapy became an integral part of Alex’s routine, with the goal to gradually increase the weight on his legs every week.
“The first time I stood and straightened to my height,” remembers Alex, “it was surreal to be standing. I had been in a wheelchair a long time and in a way, I now felt like my old self.”
Even though Alex could stand upright, he needed to learn to walk again, and no one was surprised that he tackled the challenge full throttle.
“It is such an amazing surgery,” he says. “Now when I stand up straight my kids give me a high 5 and it’s totally different from when I was sitting low in a wheelchair.”
Alex and Nicola’s children have four children: Luca and Eva, who are nine, and Ben and Ellie who are four-year-old twins. “It is a busy household and I love every minute,” he laughs. “I enjoy the noise and sometimes it’s me who initiates the craziness.”
His family is his rock. “My wife, Nicola, has been by my side the entire time, through the good and bad days, and the worst days.”
“You are still you”
Alex is back working full time as a partner in the law firm Banahan Martinez Weatherford, PLLC.
“It’s been seven years and sometimes I still need to come to terms with what happened,” he explains. “When I talk with trauma patients who are still getting used to their new reality, I don’t paint a sunny picture. You sleep and dream of running around with your kids and then you wake up and you can’t run around. It’s a tough situation, no matter what people tell you.”
He has a message to share with patients. “I remind them: ‘You are still you and you are still the same person.’ For example, if you like a sport, you can still do sports. There is a huge community in Houston for people of all abilities and you can play any sport. Even if you are blind, you can ice skate.”
After the accident, one of Alex’s hockey friends suggested he play hockey. “I’m a strong guy and now I love sled hockey,” he says. “My team went to nationals this year at the USA Disabled Hockey Festival and it was a great experience.”
Alex also competed in the Houston Marathon with a hand cycle. “I’m not going to lie,” he admits, “it was very difficult, but I was determined to finish.”
He is no stranger to overcoming obstacles “There are huge, dark moments that no one will understand unless you’ve lived it. I warn people facing major challenges, don’t lose yourself in the darkness.”
For Alex, he found bright rays of light, thanks to his intense determination to never give up, his family’s nonstop love and support, and our world-class medical team.
He is quick to point out he would do OI surgery again. “It changed my life. Now I can buy shoes again.”
**photos by Jack Thompson