Chance meeting lands man from Costa Rica mended knee|[11/24/07]

Published 12:00 am Saturday, November 24, 2007

Costa Rica native Diego Mejia Rex loves to surf and compete in motocross races, but his love of the latter came at a hefty price. A crash left him with an injury, but this Thanksgiving week he got a little help from Dr. Daniel Dare, an Vicksburg orthopedic surgeon.

Two years ago, Rex, 32, who runs a commercial tree nursery, was riding his bike and doing jumps when his front tire came off. He landed on his right leg, shattering his knee. Despite two surgeries in Costa Rica and a third in Chile, his knee still wasn’t quite right.

Meanwhile, Dare was on vacation near San Jose, the capital city of Costa Rica. He started chatting with a woman, and the two struck up a friendly conversation.

Email newsletter signup

Sign up for The Vicksburg Post's free newsletters

Check which newsletters you would like to receive
  • Vicksburg News: Sent daily at 5 am
  • Vicksburg Sports: Sent daily at 10 am
  • Vicksburg Living: Sent on 15th of each month

“We got along, and she asked me what I did,” said Dare. She told him about Rex, her son-in-law, and Dare agreed to take a look at his case. Rex’s wife, Meryus Herz, brought Dare the medical file.

“It was terrible,” said Dare. Despite all the attempts to fix it, Rex’s knee was collapsing under his weight. Sections of bone were dying, while other jagged sections were growing the wrong way. Cartilage was out of place. Doctors told him he would either have to live with the pain and the limp, or have his knee fused, which would permanently limit his mobility. Doctors also told Rex he was too young for a total knee replacement.

Dare suggested doing a CAT scan, which showed further damage. Rex needed an allograft, which Dare agreed to perform. The surgery was done this week at River Region.

“Nobody in Costa Rica does that,” said Dare.

An allograft, or allogeneic transplant is when tissue — including bone — organs or cells from a genetically nonidentical person are used to repair the body of another. Orthopedic allograft procedures, which are about 30 years old, are not used very often, said Dare. Even the doctor who has performed the most orthopedic surgeries in the world has performed only about 100 allograft procedures, Dare added.

Dare performed his first allograft in 1981. For cases such as Rex’s, where there is severe damage to major body structures, cadaver tissues are normally used. That means the timing must be just right for the procedure to be successful. Medicines that suppress the immune system are also used to prevent the recipient’s body from rejecting the transplant.

One of two orthopedic surgeons at River Region Medical Center, Dare, a graduate of Louisiana State University School of Medicine, specializes in joint replacement and reconstruction.

Rex said the chance to regain his active lifestyle was an opportunity he couldn’t pass up — despite the bills, which the couple paid mostly out of pocket. Their insurance does not cover medical costs outside the country.

Just the “parts” of the joint needed for the allograft can cost about $14,000. The high cost, Dare said, is due in part to testing to ensure the donor is healthy.

The complete procedure can approach $100,000, although Rex, thanks to River Region officials, paid about half that.

When it was all said and done, Rex had three procedures in one, six-hour operation. He now has parts of an 18-year-old knee, 13 screws and a plate holding everything together.

Rex will likely keep the screws for life. Dare said the hardware will not be removed unless it causes complications.

Still, Rex said, “it’s been incredible. The pain has been minimal. Probably, if I wouldn’t have met Dr. Dare, I would have been much worse. God puts things together in a way that you’ll never know.”

For the next three months, Rex will need crutches. He will also wear a brace that will allow him to exercise his leg while keeping pressure off the reconstructed knee. Recovery will take about a year.

Rex and his wife spent Thanksgiving with Dare in Vicksburg and will return to Costa Rica on Monday.

After his year of recovery is up, Rex said he’d like to be back surfing on the waves, but his motocross career is over.

“It’s too expensive,” he said.