Limb-sparing with bone graft
In a bone graft procedure, the cancerous part of the bone is removed and then replaced with a graft. The graft can be taken from another healthier bone (autograft) or from a cadaver (allograft). The graft will eventually become a living and growing part of the patient that is free of cancer.
This procedure is for patients whose cancer is limited to a small section of bone and whose surrounding tissues are disease free. It allows the joints and bones to stay intact and often maintains close to full function in the affected limbs after recovery. That function may vary depending on the amount of bone removed.
While the bone is healing, the child will have to use crutches if the affected bone is in the leg. There will also be some weakness following the surgery due to muscle involvement. Physical therapy can help build strength back in the affected limbs.
Limb-sparing with endoprosthesis
Sometimes the cancer affects more tissue and bone than can be replaced by a bone graft. This is when limb-sparing surgery with an endoprosthesis can be a good option. During the procedure, the cancerous part of the bone in the child’s arm or leg is removed and replaced with a metal and plastic prosthesis, a cadaver bone or a combination of both. This is called an endoprosthesis, which allows the limb to look similar as it did before the procedure.
There can be several challenges associated with limb-sparing surgery using an endoprosthesis. If the child is still growing, there will be differences in the length of his limbs because the replaced section of bone doesn’t grow. Also, while the child can have normal function with the limb, it will be weaker and more fragile. This means the child will be limited in participating in certain activities like high-impact sports.
After the surgery, the child will have to use crutches while he heals if the affected bone is in the leg. He will also experience some weakness following the surgery due to muscle involvement. Physical therapy can help build strength back in the affected limbs.
Limb-sparing with rotationplasty
Rotationplasty is a form of limb-sparing surgery for the femur (thigh bone), knee or tibia (shin bone). In this procedure, the cancerous part of the bone is removed, usually including the knee. The remaining ankle is then turned 180 degrees and connected to the rest of the leg to create a new knee joint. This procedure, while initially appearing drastic, results in more function and durability when combined with a below-the-knee prosthesis.
In some cases, amputation may be the only treatment option. In this procedure, the cancer and the rest of the limb below the cancer is removed. The loss of a limb can be scary, but our pediatric-trained specialists can help children who face this option realize an amputation will only briefly slow them down.
As prosthetic technology has advanced, so has the function and ability of patients who require an amputation. There are also a wide range of adaptive sports and activities available to these patients. To help families make what can be a difficult decision, we connect them with patients and families who have been through the same procedures and recoveries.