By
Tony Cappelletti first appeared on our radar about three years ago, when we learned about Two Dudes, Three Legs, the podcast he co-hosts. Not long after that we met him face to face at a Levitate run clinic, where he was checking out running blades along with 30 or 40 other people. That led to a fundraising campaign in which Cappelletti and his Two Dudes co-host raised more than $20,000 and bought 10 Levitate blades for people who couldn’t have afforded running prosthetics otherwise. He later got involved with Less Leg More Heart and other amputee-serving nonprofits.
And then, he says, life took over. Cappelletti’s business grew and his work demands piled up, leaving less time for advocacy. But when he decided, earlier this year, to pursue osseointegration surgery, Cappelletti saw an opportunity to support the limb-loss community in a new way: as an educator. He’s documenting his OI experience at Amputony, a new YouTube channel that aims to help viewers understand OI. It’s particularly aimed at below-knee amputees, who constitute a tiny fraction of OI patients to date. FDA approval only covers above-knee patients, and the surgical techniques are less well established for BK patients than AKs. Once Cappelletti committed to the surgery, he wanted others to benefit from his experience.
The first installment of a planned multi-part series is now live on YouTube, featuring a conversation between Cappelletti and his surgeon, Jason Hoellwarth; you can check it out here. The interview below is lightly edited for length and readability.
Get me up to speed on the circumstances that led you to try OI.
The short version is: About 20 years ago, my uncle lost his right leg in a motorcycle accident. Fast forward to 2020, on August 8—I lost my leg in a motorcycle accident. My uncle went and got the OI surgery, and he said: “It’s great, you got to go do this.”
Is he also a below-knee amputee?
Above knee. As you know, AK is always rougher. He was having massive socket issues, extreme nerve pain. His case was much worse than mine. And so he looked into osseointegration, he ended up getting it, and now he’s walking and lot better, and he has none of those issues. He still rides the same motorcycle. He’s a nut. Love him.
Were you having socket issues similar to your uncle’s? From afar, it looks like you’ve had pretty good success in a socket.
If there’s an amputee who isn’t having socket issues. I’d like to meet them. Some days it’s great and you don’t even notice it, and then some days it sucks. I ran a 5K with my socket and a blade leg, and I couldn’t walk for a week. I literally had to take a week off of work. I had to give up on a lot of stuff because I’m an entrepreneur, and I need to be available to work 24/7. If I go for a run or a hike on Sunday, that might affect me Monday. I haven’t gone on a hike in four years. It kind of sucks, because I’ve always been an extremely active person. I figured OI could be a solution to that.
In addition to that, every morning there’s a routine you have to do to prep your leg [for a socket], and that’s annoying. I wanted to take a regular shower again like I used to, instead of it being a 30-minute process. OI was a solution that covered all those bases for me.
When did you have the surgery?
I had the surgery on January 24, and now I’m in the healing process. I’m not there yet. I’m currently in the loading process, where I’m applying around 50 pounds of pressure to the implant, building up every day at about five pounds. So hopefully at the beginning of next month, I can get fitted for my new prosthesis.
OI is still rare in below-knee amputees, because the implant has to be embedded in a bone [the tibia] that’s much less thick than the femur. Did you have any reservations about that?
Great question. My uncle recommended Dr, Hoellwarth to me, and he wound up doing my surgery too. Definitely the first uncle and nephew combo to get OI from the same surgeon. Anyway, I had extensive conversations with Dr Hoellwarth. I have so little tibia left that I was almost not a good candidate for this. So I’m one of the riskier ones. If you have a patient who’s got even 50 percent of their tibia left, that’s great [for OI]. He made it work in my tibia with six centimeters. He was able to put the implant in, and now it’s healing and and it’s doing very well. If I had more tibia, I would have been a better candidate. But obviously, the healthier you are, the better candidate you’re going to be. So being young and healthy made me a good candidate.
Did anything else about the OI process make you hesitate or think hard about the tradeoffs?
I asked him if I’m going to be limited to what I can do with my leg, because I could potentially break this implant. According to him, after about six months I’ll be able to do everything that I could do before, and at the same levels. I asked him, “Am I gonna be able to get back in the gym and do squats again?” And he said absolutely, I’ll be able to do everything I was doing before and do it safely. Even if I’m not able to go into the gym and put 200 pounds on my back and squat, it’s still a trade up because I don’t have to deal with the socket and liners and all the equipment. It’s quick and easy. You put it on, you’re up, and you go. That’s the closest thing to the way my life was before becoming an amputee.
Did you bring your prosthetist into the conversation before you committed [to OI]? Not many prosthetists have hands-on experience with OI.
I was already talking about it with my prosthetist, because I’ve been doing research on it for years. We’ve spoken about it at length. And my uncle uses the same clinic I do. When he did OI, he kind of piloted the whole thing. When I told the prosthetist I’m looking into it too, he said sure. So I went ahead and got the consultation.
Were you able to talk to any other BK amputees who’ve had OI surgery?
No, there just aren’t many out there. That’s the whole reason I’m documenting this whole thing. I want to be a helpful resource and show people that this exists. Once you really get into it and break it down, it seems like this should have been the solution for a long time. It’s not even that crazy of a surgery. It’s less invasive than a knee replacement.
Did Hoellwarth have any reservations about having this shot on film?
When I approached him, I told him I planned to be documenting the whole thing. He’s trying to have a strong online presence, so he was OK with that. We actually shot a full podcast before the surgery, talking about a lot of the same questions you’re asking. If you want to know how on board he was, he put a GoPro on his head while he did my surgery. I have the full video, and we’re gonna put that online as well. He actually had two cameras going, one on his head, and someone else with an arm camera. So every second of this process is documented. I’ve got two angles of the entire surgery from start to finish.
If someone’s not crazy about graphic surgical footage, is it easy to avoid that part of the series?
Yes, there are going to be multiple layers. We’re going to do a bunch of Reels on Instagram, which are just short videos. Then we’re also going to have a three-part series that probably lives on YouTube, where part one is leading up to surgery, part two is the surgery and recovery, and part three is the victory lap: Here’s my new life with my new implant. There’s probably also going to be a 30-minute documentary with everything in it. So there are gonna be a few different forms of how this comes out, but it’ll be very well documented for however people want to consume it.
Where are you in the recovery process currently, and what’s your trajectory going forward from now?
He prescribed me to do nothing for the first two weeks—don’t touch the implant, leave it alone, make sure it’s clean. Very simple. After two weeks they did an X-ray—this is all documented on video as well—and he said the bone is healing extremely well, the incisions and skin are all healing. At that point he gave me this little attachment that goes to the bottom of the implant. Essentially, it’s just a pad. On day one, I was supposed to apply 30 pounds of pressure to the pad attached to the implant—I have a scale for this—for a total of one hour. He prescribed 10 seconds on, 10 seconds off, for 15 minutes at a go, four times a day. So essentially, on and off for an hour. Next day, I went up to 35 pounds of pressure. The following day, up to 40. And I’m just adding five pounds of pressure a day until I get up to bearing my full body weight.
Once you get to full weight bearing, will there be additional work to refine your gait? Will you need to sort of learn a new way to walk?
I’m sure they’re gonna put me into physical therapy, and I’ll document that as well. But I’m still approaching that bridge. Haven’t crossed it yet.
In the interim, what’s your mobility situation? Are you on crutches? Wheelchair?
That right there is my living nightmare. I am on crutches, and I gotta tell you, I hate crutches. I can’t even walk a glass of water from one side of my kitchen to the other. But that’s my own personal grudge with crutches. Like I said, I run a sales team, so usually I’m working from 7 am to 7 pm, and I’m out and about, running around. I’m usually very mobile. Since the surgery I’ve been home for the most part, and that’s kind of driving me nuts.
