A MAN AND HIS DOG:

Steve Posovsky and his dog Cassidy, before surgery. "We're excited but a little nervous," Posovsky said prior to the nearly four-hour surgery on July 31 at the North Carolina State College of Veterinary Medicine to attach a titanium fitting to Cassidy's truncated right hind leg....[More]

A MAN AND HIS DOG:

Steve Posovsky and his dog Cassidy, before surgery. "We're excited but a little nervous," Posovsky said prior to the nearly four-hour surgery on July 31 at the North Carolina State College of Veterinary Medicine to attach a titanium fitting to Cassidy's truncated right hind leg. If all goes well, veterinarians will attach a carbon-fiber leg to the fitting in a subsequent operation.  [Less] [Link to this slide]

Image courtesy of Philip Ruckart, North Carolina State University

PREPPING THE PUP Technicians anesthetize Cassidy and diligently remove all fur from his right hind leg for surgery. [Link to this slide]
Image courtesy of Philip Ruckart, North Carolina State University

A LEG IN GOOD HANDS:

The room is quiet, save for the rhythmic whoosh of an accordionlike ventilator machine, as Denis Marcellin-Little, associate professor of veterinary orthopedics, examines Cassidy's leg and decides where to make the first incision....[More]

A LEG IN GOOD HANDS:

The room is quiet, save for the rhythmic whoosh of an accordionlike ventilator machine, as Denis Marcellin-Little, associate professor of veterinary orthopedics, examines Cassidy's leg and decides where to make the first incision.  [Less] [Link to this slide]

Image courtesy of Philip Ruckart, North Carolina State University

MODEL PATIENT:

A computer screen in the operating room shows an x-ray of Cassidy's leg. Computed tomography images, made from a series of x-rays, helped engineers create a plastic model of Cassidy's stump and design a titanium implant to fit the remaining leg bone....[More]

MODEL PATIENT:

A computer screen in the operating room shows an x-ray of Cassidy's leg. Computed tomography images, made from a series of x-rays, helped engineers create a plastic model of Cassidy's stump and design a titanium implant to fit the remaining leg bone. "The first model took two months," says Ola Harrysson, an assistant professor of engineering at N.C. State. "Now it takes a few days to build a model."  [Less] [Link to this slide]

Image courtesy of Philip Ruckart, North Carolina State University

CUT TO THE CHASE:

Marcellin-Little and his team make the first incision and begin to clear away the skin and muscle. The room is still quiet as the surgeon and his assistants speak softly, their voices muffled by their surgical masks....[More]

CUT TO THE CHASE:

Marcellin-Little and his team make the first incision and begin to clear away the skin and muscle. The room is still quiet as the surgeon and his assistants speak softly, their voices muffled by their surgical masks.  [Less] [Link to this slide]

Image courtesy of Philip Ruckart, North Carolina State University

TRIM AND FIT:

Marcellin-Little exposes the right tibia bone as assistants toss bloody gauze pads into trash cans. The whir of a small electric saw begins, and the surgeon trims the bone to a predetermined length so that the implant can fit....[More]

TRIM AND FIT:

Marcellin-Little exposes the right tibia bone as assistants toss bloody gauze pads into trash cans. The whir of a small electric saw begins, and the surgeon trims the bone to a predetermined length so that the implant can fit.  [Less] [Link to this slide]

Image courtesy of Philip Ruckart, North Carolina State University

MARGINAL PERFORMANCE:

Harrysson measures a plastic model of Cassidy's leg bone. As Marcellin-Little cuts the bone and contours it using a drill-like tool, he consults with Harrysson on how much to cut....[More]

MARGINAL PERFORMANCE:

Harrysson measures a plastic model of Cassidy's leg bone. As Marcellin-Little cuts the bone and contours it using a drill-like tool, he consults with Harrysson on how much to cut. The team takes off a few more millimeters than they had originally planned, but they can make up for the lost length with the new prosthetic attachment, Harrysson says. Ideally, the bone and titanium attachment should be separated by no more than half a millimeter, to ensure that the bone fuses properly, he adds.  [Less] [Link to this slide]

Image courtesy of Philip Ruckart, North Carolina State University

A LITTLE PERSUASION: Using a mallet, Marcellin-Little assertively taps the titanium piece to make sure it fits onto the bone. [Link to this slide]
Image courtesy of Philip Ruckart, North Carolina State University

PINNING IT DOWN: The team drills through the bone to create space for two titanium pins that will secure the fitting, which cups the bone. [Link to this slide]
Image courtesy of Kelly Rae Chi

SUTURE, CLOSE—AND CHOW-DOWN:

With the bulk of the nearly four-hour surgery over, the veterinarians and engineers start murmuring about lunch. It takes about an hour for the team to suture the muscle and skin to the holes in the titanium....[More]

SUTURE, CLOSE—AND CHOW-DOWN:

With the bulk of the nearly four-hour surgery over, the veterinarians and engineers start murmuring about lunch. It takes about an hour for the team to suture the muscle and skin to the holes in the titanium. They must make sure the skin and muscle aligns with the titanium to allow Cassidy to be able to flex and extend his stump. By October, if the tissue has successfully fused with the implant, Cassidy will receive a metal leg. The researchers will later attach a device that will measure the leg's motion and calculate the physical forces, Harrysson says, which will help them tweak limb design for Cassidy and others.  [Less] [Link to this slide]

Image courtesy of Philip Ruckart, North Carolina State University

CASTING FOR PERFECTION: The plastic models of Cassidy's bone sit at a nearby table. An engineering doctoral student who viewed the surgery took notes on future tweaks the team will make to the implant design. [Link to this slide]
Image courtesy of Kelly Rae Chi