Knee replacement together with management of a femoral tumor

17/08/2020 14:52

It was considered as a complicated surgery for both osteoarthritis of knee and bone tumor before it destroys a femur.

 

A male patient N.X.T., 63 years old, who lives in Ky Ba Commune, Thai Binh City, has a history of knee pain in last 5 years. More than a month ago, Mr. T. slipped, got injured and limited mobility, and his knee joint was only folded 20^o (while the normal knee joint can be folded  from 100 – 120^o). Then he was transferred to Viet Duc University Hospital (VDUH) for a consultation.

 

Ass. Prof. Nguyen Manh Khanh – Vice Director of Trauma and Orthopedic Institute, Chief of Upper Extremities and Sport Medicine, VDUH said: it was a very difficult case because only one operation for removing a tumor and grafting bone the osteoarthritis in knee is not resolved and the patient was still painful.

 

In contrast, if we do not manage the bone tumor, juts only treat for the osteoarthritis in knee, thus the tumor would destroy the femur. After carefully having checked and discussed, surgical team decided to manage both problems.

 

Surgeons were replacing a knee joint, removing a femur tumor for a male 63 year old patient

 

During the operation, surgeons checked and saw the cyst located in the external femoral tuberosity, and bone fragments caused bleeding in the joint. The surgeons removed the tumor, performed debridement of tumor tissues, grafted bone  into the site of bone loss; together with management of knee osteoarthritis.

 

Now, after a week of post-operation and intensive care, Mr. T. was discharged from the hospital. He is requested to have a regular health check for his knee’s recovery.

 

Ass. Prof. Nguyen Manh Khanh affirmed that in this case, he have gotten a bone tumor for a long time but didn’t know.

 

Over time without management, the tumor destroys the bone and makes it easily to be broken even with a minor injury. A bone fracture on osteoarthritis will make the knee replacement become more difficult, because many lesions must be handled at the same time.

 

“If this case was diagnosed at early stage without osteoarthritis, the doctor would remove the tumor and be proactive to graft bone. Or if doctor knew that the patient had both osteoarthritis and bone tumor, the patient would undergo early surgery to prevent visiting hospital in late with injury or serious bone fracture caused by fall or trauma”, Ass. Prof. Khanh said.

 

 

 

The experts in medicine recommend that the people have to visit and be examined by specialized doctors whenever having a pain in joint to be evaluated by x ray and predicted the injured level for proper treatment.

 

When tumor is detected, patient needs to be treated timely before the tumor really affects to the motor skill of limbs, especially those with high rate transition to malignancy.