What is Limb Reconstruction?
Limb reconstruction surgery, as related to orthopedic oncology, is a complex operation performed to replace the portion of the limb which is surgically removed during the excision of a cancerous bone tumor with a bone graft, an internal prosthesis, or a combination of both. The advances in imaging modalities, multiagent chemotherapy, and reconstructive techniques have made limb reconstruction the standard of care for the treatment of most extremity bone cancers.
Indications for Limb Reconstruction
Patients that may benefit from limb reconstruction surgery are those who have had:
- Surgery to remove a bone tumor
- Failed healing of broken bones
- Traumatic limb injury
Limb Reconstruction Materials
Materials used for limb reconstruction may include metal plates, screws, rods, bone grafts, bone cement, and bone and joint prostheses.
Preparation for Limb Reconstruction
Specific instructions will be provided by your surgeon. The limb reconstruction is usually performed at the same time as the surgery to remove the tumor. Multiple imaging tests will be performed to determine the extent of the tumor. You will be required to stop eating 8-12 hours prior to the surgery, avoid smoking as it can slow down the healing process, and inform your surgeon about any health conditions, allergies, and regular medications.
Limb Reconstruction Procedure
- The surgery will be performed by a multidisciplinary team.
- Regional or general anesthesia may be used for the limb reconstruction procedure.
- The orthopedic surgeon will excise the tumor along with a margin of healthy tissue from the bone.
- The deficit in the bone will be replaced with a bone graft obtained from the patient or a donor.
- Joint replacement will be performed if necessary.
- The bone will be stabilized with metal rods, plates, and screws.
- The vascular surgeon will reconstruct the circulatory system.
- The plastic surgeon will help with muscle transfers and microvascular repair.
- The surgery may take anywhere from 2 to 8 hours depending on the extent of the tumor.
Recovery after Limb Reconstruction
Recovery from limb reconstruction takes about 6 weeks to 6 months. A physical therapist will provide a personalized program to help the patient learn to perform activities of daily living with the reconstructed limb.
Risks and Complications of Limb Reconstruction
Possible risks of limb reconstruction include:
- Aseptic loosening of joint implants
Benefits of Limb Reconstruction
Limb reconstruction surgery can help to:
- Restore limb anatomy
- Optimize limb function
- Minimize risk of implant failure