As our technology improves, so too does our ability to make prosthetic devices, whether internal (eg total femoral replacement) or external (eg below knee prosthesis – artificial leg). Anyone with even a passing interest in the Olympics will be aware of the South African sprinter who is a double below-knee amputee, competing with able-bodied athletes at the highest levels.
If we can get this level of function out of artificial limbs, why try to save a limb that is cancerous? Many reasons, most of which are obvious . . .the way it looks, sensation, mobility . . . and those which are harder to articulate . . . its my leg!!
The goal of orthopaedic oncology could perhaps be described as to save life, save limb and to restore function. Unfortunately, sometimes we can’t achieve all three at the same time.
There are a huge range of artificial bone reconstruction options available; we can replace half your pelvis, or your whole shoulder blade, or the top half of your leg bone . . . but what has to be remembered is there is no difference in long term survival (limb salvage vs amputation).
This is a very difficult decision to make, and we will do our utmost to help your come to the best decision for your particular situation.
Tumour prostheses (megaprostheses)
There a wide variety of prosthetic options available for reconstructing bone defects after large excisions for bone cancers, or severe bone loss after trauma or infection.
With both off-the-shelf and bespoke options, any long bone (arms and legs) can be replaced in either their entirety, middle sections, or top or bottoms halves. As most of these replacements involve removing the joint as well, in younger patients bespoke implants can be made allowing preservation of the native joint surface, allowing more natural movement eg knee joint-sparing proximal tibial replacement.
It is also possible to create custom implants for children that are able to grow with the child, to enable equal leg lengths (or arm lengths) at skeletal maturity (Stanmore Implants, UK).