On January 30, information from Can Tho Central General Hospital said that doctors at the hospital's Orthopedic Trauma Center had successfully performed surgery on a case of a large tibial tumor invading soft tissue using the long-stem knee replacement method. This is considered the first time this technique has been performed in the Mekong Delta.
Doctors from the Orthopedic Trauma Center, Can Tho Central General Hospital perform surgery on a patient.
Previously, patient LTBN, 59 years old, residing in Ninh Kieu District, Can Tho City, was brought to Can Tho Central General Hospital by his family in a state of severe pain in his left knee and limited mobility. About 6 months ago, the patient suffered a left knee injury due to a traffic accident. After that, the left knee was often swollen and painful when standing, moving, and making daily activities very difficult.
MRI results of the patient's left knee showed: Destruction of the left tibia's upper head bone, invasion, destruction of the bone cortex, spreading to the joint surface, size 5.5 cm x 5.7 cm x 6.7 cm, surrounding soft tissue edema. The patient underwent surgical biopsy to remove tumor tissue from the upper tibia for pathological analysis, the diagnosis was macrocytic tumor.
This is a very difficult case when a large macrophage tumor invades almost all soft tissue and the left knee joint surface, related to large blood vessels and nerves in the left popliteal region. Early surgery is needed to limit the risk of bone destruction.
After consultation, the doctors chose the option of cutting the tumor and replacing the patient's knee with a long-stem artificial knee joint; in which, the long-stem functions to replace the cut bone segment.
More than 10 doctors and nurses divided into 2 teams performed surgery on the patient. First, the doctors dissected, cut the tumor wide and cut down the tibia about 12 cm from the tibial plateau, checked all tumor tissue, and dissected blood vessels and nerves.
Immediately after that, the second team performed a total left knee replacement with a long-hinge hinge, while rotating the gastrocnemius flap to cover the missing bone. The surgery was successful after 5 hours.
Currently, after surgery, the patient is awake, the surgical wound is dry, the feet are warm and pink, the ankle and toes move well, the patient has practiced standing and walking with a frame.
After surgery, the patient was awake and the recovery process was going smoothly.
Dr. Duong Khai, Head of the Department of Joint Replacement and Orthopedic Oncology (Orthopedic Trauma Center, Can Tho Central General Hospital) said: Surgical treatment of bone cancer or large bone tumors causing bone destruction as before is still wide excision of the bone tumor and joint fusion or limb amputation. The above method often leaves severe psychological and functional sequelae after surgery, greatly affecting the quality of life of the patient, especially young patients.
"In the world, the application of long-shaft artificial joints is one of the advances in science and technology applied to medicine. Specifically, in this case, doctors use a long-shaft hinged artificial knee joint to replace the upper part of the tibia that has been removed. Currently, this surgery is only performed at major orthopedic trauma centers in developed countries. In Vietnam, this is the first surgery performed in the Mekong Delta, opening up much hope for patients with bone tumors to still be able to have limb-preserving surgery, restore joint function and help patients recover better," said Dr. Khai.
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