Limb Salvage Surgery

What is Limb Salvage Surgery?

Limb salvage surgery is a surgical procedure aimed at removing a tumor (typically a bone or soft tissue tumor) while preserving the limb (arm or leg). Instead of amputating the affected limb, the surgeon removes the tumor and then reconstructs or replaces the damaged bone or joint. This allows the patient to keep their limb, providing a chance for better function and quality of life compared to amputation.

What is Tumor Mega prosthesis?

A tumor megaprosthesis is a large custom prosthetic device used to replace a bone or joint that has been removed due to a tumor. It is typically made of metal alloys such as titanium or cobalt-chromium and is designed to restore the function and shape of the limb after a tumor has been removed. Megaprostheses are commonly used in limb salvage surgery for tumors in the femur, tibia, humerus, or pelvis.

What are the Advantages of Mega prosthesis?

• Preservation of the limb: The main benefit is that it allows for the preservation of the limb, reducing the need for amputation.
• Restoration of function: The prosthesis helps restore the function of the affected limb, improving mobility and allowing the patient to perform daily activities.
• Durability: Megaprostheses are made of strong, durable materials that can withstand regular use and stress.
• Cosmetic benefit: In many cases, megaprostheses help maintain a natural appearance of the limb, improving the patient's self-image.

What are the Disadvantages of Mega prosthesis?

• Risk of infection: As with any surgical implant, there is a risk of infection at the surgical site or around the prosthesis which varies from 10-20 percent.
• TRevision Surgery: Wear and tear: Over time, the prosthesis may wear down, potentially requiring replacement.
• Risk of mechanical failure: Although rare, there is a risk that the prosthesis might break or fail, which could require another surgical procedure.

Can Patients Lead a Normal Life with Mega prosthesis?

Yes, many patients can lead a normal or near-normal life after receiving a megaprosthesis. While there may be some limitations on activities such as contact sports or high-impact exercises, most patients are able to walk, climb stairs, drive, and perform everyday tasks. Rehabilitation and physical therapy are key to regaining strength and mobility after the procedure. The goal is to help patients return to their usual lifestyle as much as possible, and many patients report a good quality of life after undergoing limb salvage surgery with a megaprosthesis

What is Extra-Corporeal Radiotherapy of Bone (ECRT)?

Extra-corporeal radiotherapy of bone (ECRT) is a treatment method primarily used for bone cancers such as osteosarcoma, Ewing’s sarcoma and chondrosarcoma.

• The tumor or a portion of the affected bone is surgically removed from the body.
• The tumor is then radiated outside the body (extra-corporeally) using high-dose radiation. This will kill all the cancer cells.
• The tumor or bone is then re-implanted back into the patient after radiation treatment, aiming to eliminate any residual cancerous cells while maintaining the structural integrity of the bone.

What are the Advantages of ECRT?

Increased Precision:

• Preservation of the limb: The major advantage of ECRT is that it helps preserve the affected limb. By irradiating the tumor outside the body, it allows the surgeon to remove the tumor while keeping the natural bone intact, reducing the need for amputation.
• Effective tumor control: ECRT targets and kills any remaining cancer cells in the tumor, improving the chances of complete tumor eradication and preventing recurrence.
• Maintaining bone function: After successful re-implantation, patients can maintain a better range of motion and functionality in the affected limb compared to an amputation or full bone replacement.
• Reduced need for prosthetic limbs: Since the natural bone is saved, there is often no need for artificial prosthetic devices, which can be complex and require additional maintenance.
• Reduces the need of revision surgery

What are the Disadvantages of ECRT?

• Risk of infection: Since the bone is surgically removed and re-implanted after radiation, there is a risk of infection at the surgical site or in the irradiated bone.
• Healing complications: The healing process may take longer for bones treated with radiotherapy, and there can be complications such as non-union (failure of the bone to heal) or bone weakness.

Can Patients Lead a Normal Life with ECRT?

Yes, many patients can lead a normal life after ECRT, especially if the treatment is successful and there are no major complications. After the re-implantation of the treated bone, rehabilitation and physical therapy are crucial to restore function and strength. Patients can expect to regain mobility and return to most daily activities, including walking, driving, and participating in light exercise.
However, there may be some long-term restrictions in terms of high-impact activities or sports due to the potential for bone weakness or fracture in the irradiated bone. The ability to resume a normal lifestyle depends on the tumor's location, the extent of radiation, and the patient’s overall health.