Limb Salvage & Revision Arthroplasty Surgery
Novel surgery to save dying limbs
Dr SaminathanSuresh Nathan (second from left) is about to start a limb salvage surgery with a multi-disciplinary team.
Limb salvage and revision arthroplasty surgery is a unique orthopaedic specialty. This specialty might be heard referred to as musculoskeletal or orthopaedic oncology. While as a limb salvage surgeon, one must perform a wide range of general orthopaedic procedures in particular primary joint replacements of the shoulder, hip and knee; as well as arthroscopic procedures of the shoulder and knee.
Dr SaminathanSuresh Nathan is a Senior Consultant, Limb Salvage and Revision Arthroplasty Surgery at Mount Elizabeth Hospital, Singapore. His sub-specialty of some distinction are revision arthroplasty (if a joint replacement is not working well it may need special re-evaluation), bone and soft tissue tumors (the full spectrum of biologic and prosthetic options), bone metastasis (including working with primary healthcare providers in optimising home care).
Recently he visited Bangladesh on a professional purpose and shared his views with Star Health regarding this new area of critical healthcare.
While describing the new specialty, Dr Nathan explains that limb salvage actually involves all branches of orthopaedics to a patient who has reached end point and most physicians replies that there is nothing do any more suggesting just an amputation. This may be because of trauma, replacement surgery, displacement of the implant and so on.
So the treatment is actually not of only the limb, it is treatment of all body in fact. The specialty involves several disciplines where every case is unique. As a whole, the treatment offereed is individualised to a patient — sometimes it requires prosthesis / bone transplant / recycling the patient's own bone /borrowing bone form other persons etc. It really depends on the exact cause of the problem and finding the solution. In that regard, limb salvage surgery is an extremely versatile discipline.
Dr Nathan mentioned about some of his cases. For example: a child came from Indonesia with a type of bone cancer (Ewing's sarcoma) at the age of 5. She was offered an amputation everywhere she went. But Dr Nathan was able to not only save her leg but in the process he was able to save her growth centers and she continues to grow 5 years later. He had to perform a bone transplant from an adult arm bone to her leg.
Another girl had a tumour in her tibia (leg bone) which was resected and replaced with a megaprosthesis. The knee cap however detached in the process. Dr Nathan pioneered a way to reattach this onto the prosthesis using a tissue engineered device.
Another patient had a fractured tumour in his hip and nearly had to be amputated. Dr Nathan deviced a method using cryosurgery to recycle his pelvis and re-implant it and then cut his tumour out and replaced it with a prosthesis. The patient is now can walk with this prosthesis intact.
Dr Suresh Nathan maintains a portal www.limbsalvagesurgery.com that he uses as an educational tool for doctors and patients. He hopes that the information gathered in the website would give a better idea of available procedures.
Zahid Khan, Director, ParkwayHealth Patient Assistance Centre at Dhaka, Bangladesh said, "Now there is hope for these type of critical patients who otherwise would lost the meaning of life." They are available to provide with more information through their hotlines
88-02-8850422 & +88-017-13000600.
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