The patient aged 20-year old visited Lifeline Hospital with complaints of swelling around the knee along with pain, shortening, and difficulty in walking for the past 18 months.
The patient had a history of Osteosarcoma of the right thigh bone which was diagnosed at the age of 16 for which he underwent an excision of the cancerous bone and muscles, and a major bone and joint replacement surgery of the right thigh and knee (Wide Excision and Distal Femur Total Knee Replacement Megaprosthesis) in Mumbai. The patient also had Osteosarcoma of the lungs for which he underwent surgery a year later with many chemotherapy sessions.
He was able to walk comfortably for two years but then he felt the implant had become loose and was moving inside. Due to COVID-19 restrictions, he could not travel to India and learned to live with the pain. He later noticed a swelling around his thigh which grew over 6 months. The biopsy showed evidence of recurrence of cancer in the same region of the thigh. He panicked and immediately packed his bags, flew to Chennai to get a second opinion.
After discussion with the Orthopaedic, Oncology and Plastic surgery team at Lifeline Hospital, he then underwent the operation where his implants was removed and the mega prosthesis was replaced with a strong custom made titanium implant.
Commenting on the success of the surgery, Dr. Thineshchandar Andiappan, Orthopaedic Surgeon, Lifeline Hospital said, “ This was quite a complicated and rare case as we found around 130ml of serious fluid within the muscles and around the implant which explains the loosening of the implant. Fortunately, the fluid was not infected but recurrence of cancer had taken place from the muscles this time, unlike the previous time which was from the bone. We had to redo the same surgical procedure that he had gone through earlier (replacement of lower half of thigh bone with Knee joint) while the osteosarcoma was excised and the plastic surgeons did a muscle flap cover over the raw area. We however replaced the Steel implant with a Custom made Titanium implant made in India specifically designed for the patient to regain his height. The surgery lasted over 10 hours involving a large team of orthopaedic and plastic surgeons and we as well the patient is happy with the outcome.”
“Total Knee Replacement Surgery is a highly complex procedure seems as there are multiple factors involved such as length of the leg, height of the patient especially young ones as they constantly keep growing. We had to think beyond just a normal surgery for this case as we had customized the titanium implant specifically designed for the patient after measuring his height and length of leg through multiple scanning. This required advanced medical infrastructure, which was available at our facility and this gave us the confidence to take up such a complicated case and handle with ease. Another important point to note is that we procured this implant from a Chennai based company while most hospitals use foreign brands which might be much more expensive. I would like to congratulate Dr. Thineshchandar Andiappan and his team for taking up this complicated case and making it a huge success thereby helping the young boy to go ahead with his life normally. “, said Dr. JS Rajkumar, Chairman & Chief Laparoscopic Surgeon, Lifeline Hospital .
The patient has recovered well over the past two weeks and was discharged and is currently expecting to return soon to Bangladesh so he can finish his 12th Std exams which he was not able to attend the past 2 years due to this condition.