OSS Salvage Prosthesis for Bone Tumors

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OSS Salvage Prosthesis for Bone Tumors

Dr. Guillermo Claverie
FUNDAORTO
Hospital Multimédica

MIGUEL ANTONIO ARMIS HERNÁNDEZ, 29 years of age, consulted Fundación Guatemalteco Americana de Cirugía Ortopédica Avanzada (FUNDAORTO) (Guatemalan-American Foundation for Advanced Orthopedic Surgery) on March 13th, 2012. He had a history of having a big mass in the distal end of his right thigh involving the knee joint, which prevents him from performing the normal movements of flexion and extension, and at the same time, preventing him from walking normally.

Preoperative radiograph


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Miguel Antonio Armis commented on having visited the Roosevelt Hospital in 2011, where X-ray studies were performed, and he was diagnosed with a giant-cell tumor involving the distal end of his right femur. Subsequently, in that same hospital, he was subjected to a surgical intervention where an excisional biopsy of the tumor was performed, which was sent to Pathology (in the same hospital), and the report was of a multi-nucleated giant-cell tumor. Because of the size of the bone tumor, and the complete destruction of the right femur in the distal end caused by the tumor, the patient was referred to Hospital del INCAN, where he was evaluated. In that center, he was offered the alternatives of an amputation at the middle third of the femur, or the placement of a tumor prosthesis for his right inferior limb.

Diagnostic Tests

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Pictures courtesy of Ligia de Claverie

Because of the alternatives mentioned previously, and not counting with the necessary economical resources, he consulted FUNDAORTO, where he was evaluated by Dr. Guillermo Claverie, who confirmed the giant-cell tumor diagnosis.

Right Knee

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The option of performing a surgical resection of the tumor, which, because of its size, would require elimination of basically all of the distal end of the femur was discussed, as was the placement of a salvage prosthesis designed especially for these types of tumors.

Prosthesis

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Due to the complexity of the surgery and the exaggerated size of the tumor, an expert medical team was needed, including Dr. Guillermo Claverie, Dr. Álvaro Collia, and Cardiovascular Surgeon Dr. Rudolf García-Gallont.

Bottom line

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After the surgical resection, the patient left the operating room in perfect conditions and was able to walk with no problems the following day, after two years of using crutches, and no support..

Postoperative radiographs

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Because of the high cost of the prosthesis, Dr. Claverie knocked on several doors of friends and private altruistic institutions, who did not spare any effort to get the funds to pay for the prosthesis, approximately Q. 98,000.00.

Ligamentous instability

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Court right knee and the femur

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esection of tumor

They proceeded to surgically intervene the patient, on June 4th, 2012, in Hospital Multimédica,where the resection of the bone tumor in the middle third of the femur was performed.

Prosthesis Placed

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Type hinge system

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Next, they proceeded to place the OSS salvage prosthesis to reconstruct his femur, the knee joint and the proximal end of the tibia.

Pathology Report

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Two months after the surgical intervention, the patient is walking with no pain and no help from a cane or walker, with complete extension of his right knee, as well as a 90 degree flexion of the joint. The patient is very satisfied with the results and is currently looking for a job to reintegrate himself into the economically active population of Guatemala.

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This surgery had no cost for the patient