World-Renowned OrthoCarolina Physicians Create First-of-its-Kind Multidisciplinary Multi-Extremity Limb Loss Program

CHARLOTTE, North Carolina (Sept. 12, 2024) – OrthoCarolina, one of the nation’s leading orthopedic practices based in Charlotte, N.C., announced today the creation of a first-of-its kind multidisciplinary multi-extremity treatment program for amputees that includes cutting-edge surgeries as well as virtual reality (VR) therapy to reduce phantom limb pain, curbing the use of opioids and other serious medications and getting patients back to their lives faster.

The program was created by physicians Dr. Glenn Gaston and Dr. Bryan Loeffler, world-renowned multi-extremity limb loss specialists who founded OrthoCarolina’s Reconstructive Center for Lost Limbs (RCLL), a multidisciplinary program that involves specialists across the continuum of care, including therapists, prosthetists, and psychologists, and includes partnerships with Atrium Health and the Hanger Clinic. As a physician-led entity with experts across the gamut of orthopedic subspecialties, OrthoCarolina intimately understands the medical landscape and prioritizes research to create global breakthrough treatments. Drs. Gaston and Loeffler have used their revolutionary innovations to treat hundreds of patients through the RCLL, including hosting clinics twice a month for amputee patients, many of whom travel thousands of miles to see these best-in-their-field physicians. Earlier this month, the doctors received the Charlotte Business Journal’s “Health Care Innovator” award for their revolutionary work. 

Multi-extremity amputees treated by this comprehensive care program typically complete treatments within eight to 10 weeks and can fully use their prosthetics upon leaving. This program, which focuses on expedited return to function, typically includes a one-month hospital stay for surgery and initial recovery, followed by a one-month inpatient rehab stay. 

Of the more than 2.7 million Americans who have experienced limb loss, approximately 80% suffer from phantom limb pain, an extremely painful condition where the brain continues to receive pain signals from the nerves that originally carried impulses from the missing limb, creating the sensation of pain in a limb that’s no longer there. Traditionally, phantom limb pain has been treated with opioids, muscle relaxants, and antidepressants and is notoriously understudied, leaving patients with limited options for effective treatment. 

However, Drs. Gaston and Loeffler’s multi-pronged approach to amputation recovery and rehabilitation combines innovative surgical strategies such as Targeted Muscle Reinnervation (TMR) to manage residual limb pain and a novel investigational Targeted Brain Rehabilitation (TBR) program to manage phantom limb pain. Together, these treatments show great promise as an optimal pain management strategy for patients.

TMR involves redirecting nerves that previously controlled the missing limb and connecting them to nearby muscles that are working properly, while TBR employs VR technology designed to train the part of an amputee’s brain previously devoted to feeling and controlling the missing limb.

Improving the health of this part of the brain allows patients to address the neurological root cause of their pain rather than masking it with medication, with a goal of having all patients off pain medications prior to discharge. The physicians at OrthoCarolina are continuing to research, evolve, and scale these treatments in the hopes of creating maximum global impact.  

“One of the most rewarding parts of our careers as physicians is finding solutions that empower our patients, and that’s exactly what our two-pronged approach, in particular our virtual reality program, is doing,” said Dr. Gaston. “Not only does this program give patients the ability to actively treat their pain, but it also sets them up for holistic recovery by limiting their need for opioids and other medications that can delay them from getting back to their lives.”

Most recently, Drs. Gaston and Loeffler oversaw the treatment and care of Lulu Gribbin, 15, from Mountain Brook, Ala., who lost her right leg and part of her left arm in a shark attack earlier this summer. The Gribbins selected OrthoCarolina for Lulu’s care specifically because of the world-class expertise and industry-leading treatments spearheaded by the two physicians. 

Lulu arrived in Charlotte on June 12, just five days after the incident, and immediately began working with OrthoCarolina. Lulu was managed surgically with TMR for both her arm and leg to minimize residual limb pain and maximize prosthetic control. She was also managed with early TBR using virtual reality in an effort to prevent phantom limb pain from developing. After just two months, Lulu was able to walk out of the rehab center with her prosthetic leg and use a robotic arm while taking no pain medicines, highlighting the efficacy of the doctors’ dual TMR-TBR pain management approach.

“Some patients just remind you why you became a doctor, and Lulu was one of those patients,” said Dr. Gaston. “Her success has been a beautiful combination of her inner strength merged with years of our research, and she was – and remains – an inspiration to her entire healthcare team and other patients.”

Dr. Loeffler added, “Our goal is to give patients the absolute best and most comprehensive treatment possible, and fortunately – through years of work – this treatment continues to improve. With an inspiring and remarkably positive attitude, Lulu took full advantage of the treatment and rehabilitation opportunities which enabled her to recover and progress at a blistering pace.”     

After seeing firsthand the benefits of virtual reality treatment and in an effort to expedite its research and development, the Gribbin family has created the LuluG.Strong Foundation. Honoring Lulu’s story and journey, the foundation will seek to raise money for further research into the use of VR to treat phantom limb pain, particularly for lower extremity amputations. While Lulu was able to receive comprehensive VR treatment for her arm, more research is still needed to create a lower extremity VR counterpart. 

"We’ve seen firsthand the power and efficacy of the treatments that Dr. Gaston, Dr. Loeffler, and the OrthoCarolina RCLL team provide,” said Lulu’s mother, Ann Blair Gribbin. “They’ve given Lulu the chance to embrace her next chapter with renewed hope and confidence – and we are committed to paying it forward by ensuring that others facing limb loss have access to the same exceptional care. Through the LuluG.Strong Foundation, we hope to raise awareness and funds for further research so that more individuals can experience the incredible advancements in recovery that OrthoCarolina has pioneered.”

For more information visit www.orthocarolina.com. Patients interested in the program can reach out to the physicians by emailing amputee@orthocarolina.com.