For the first time at K Hospital, doctors from the Department of Orthopedic Surgery successfully performed a growth-related knee replacement surgery for a 10-year-old patient with bone cancer at the lower end of the femur. This is a major step forward in limb preservation treatment for children with bone cancer in Vietnam, opening up new hope for many children with serious illnesses.
Patient KPM, 10 years old, from Dien Bien , Ha Nhi ethnic group, was hospitalized with prolonged pain and swelling in the left thigh, making it difficult to walk. Through clinical examination and imaging tests, MRI results showed that patient M. had a 12x9cm lesion at the lower end of the femur, eroding the bone cortex, breaking the periosteum and spreading to the soft tissue. Biopsy results confirmed that the patient had osteosarcoma of the lower end of the right femur - a malignant bone cancer commonly found in adolescents.
Specialist II Doctor Hoang Tuan Anh - Head of the Department of Orthopedic Surgery, K Hospital said that, assessing the current condition and health of the child patient, if not treated and intervened promptly, the child may encounter many obstacles in walking and life later, so the doctors conducted a multidisciplinary consultation including the Department of Orthopedic Surgery, Internal Medicine, Diagnostic Imaging, Pathology for a thorough assessment, the child patient was prescribed adjuvant chemotherapy to shrink the tumor before surgery. The child patient was treated with 2 cycles of preoperative adjuvant chemotherapy according to the MAP regimen. Post-treatment evaluation showed that the tumor was localized and reduced in size.
The difficult choice between amputation and preservation with growth joints
Usually with bone cancer in children, especially in the area near the knee joint, the risk of affecting limb development is very high. Previously, most cases would be indicated for amputation to ensure radical treatment. However, with the development of surgical techniques and artificial joint technology, limb preservation treatment by artificial knee replacement has become a viable option.
However, this patient is only 10 years old, there is still a lot of time for growth and height development. If only replacing the artificial joint normally, it will certainly affect the ability to develop the length of the left femur, causing the patient's left leg to be shorter than the right leg in the future. This will significantly affect the patient's motor function as well as aesthetics and quality of life in the future.
After careful evaluation, the surgical team decided to perform a growth-inducing artificial knee replacement, which not only helps the patient preserve his limb but also maintains normal development of his right leg in the following years. This is a specially designed artificial joint that allows the patient to adjust the length of his left leg to match the growth of his right leg with only a small surgery. However, this is a technique that has been performed for the first time at K Hospital as well as in Vietnam, requiring high expertise from the surgeon and surgical team.
Another obstacle came when the cost of joint replacement surgery was very high and not covered by insurance while M.'s family was an ethnic minority with extremely difficult economic conditions. Faced with such difficulties, but with the determination to save the patient's limb, the Department of Orthopedic Surgery as well as the Department of Pediatrics coordinated with the hospital to connect the patient's family with benefactors willing to pay the entire cost of surgery.
Under the direction of Specialist Doctor II Hoang Tuan Anh - Head of the Department of Orthopedic Surgery, together with Master, Resident Doctor Hoang Le Minh - Deputy Head of the Department, the team ordered the transportation of artificial joints from abroad to Vietnam to ensure the most suitable for the patient, ensuring personalized treatment for each patient.
The surgery lasted 4 hours, including cutting the damaged femur up to 16cm long, preserving as much healthy tissue as possible and placing the knee growth joint. Notably, the growth joint uses the external mechanical principle (external magnetic drive) allowing for future lengthening through small, minimally invasive surgeries.
Patient's positive recovery opens up great hope for the future
After surgery, the patient was cared for in the Intensive Care Unit and had an X-ray taken to check the artificial joint system was in the correct position. The patient was then instructed to do physical therapy immediately after surgery. Currently, 1 week after surgery, the patient is recovering well, the surgical wound is healing well, there are no complications of bleeding or infection, the patient can stand up and walk gently.
The patient will continue to undergo rehabilitation exercises to ensure a return to normal life. In the future, the patient will undergo surgery to adjust the length of the artificial joint to match the growth in length of the right leg.
Dr. Hoang Tuan Anh shared: “This is the first time we have performed growth knee replacement for children at K Hospital. The surgery not only opens up opportunities for comprehensive recovery for children but also marks a step forward in limb-preserving bone cancer treatment in Vietnam. The most important thing is to preserve the function and future development of children.”
Source: https://nhandan.vn/lan-dau-tien-trien-khai-phau-thuat-thay-khop-goi-ban-le-tang-truong-cho-benh-nhi-ung-thu-xuong-post898005.html
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