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Orthopedic oncology

Orthopedic oncology involves the diagnosis and treatment of malignant disorders of the musculoskeletal system. Orthopedic oncologists treat conditions such as:

Our orthopedic oncologists have expertise in diagnosing and treating malignant musculoskeletal diseases. Orthopedic oncologists perform a variety of procedures to remove tumors, reconstruct the bones, if necessary, and help patients restore mobility and/or relieve symptoms.

Bone cancer and sarcoma may require a combination of treatments and therapies. An orthopedic oncologist may use targeted procedures to remove tumors or reconstruct bone. These treatments and therapies are also designed to help restore limb mobility, enhance function and manage pain.

Procedures an orthopedic oncologist may perform include:

Amputation

Amputation is the surgical removal of all or part of an extremity or limb. This surgical procedure may be used to remove cancerous bone tumors from the arm or leg; however, doctors typically consider other options first, such as limb-salvage surgery, which attempts to save the affected limb.

Amputation for bone cancer is usually reserved for cases in which the limb would otherwise be left without good function. When amputation is used to treat cancer, your doctor removes the limb with the tumor as well as healthy tissue above it. During the surgery, a pathologist will use MRI scans to examine the tissue to help decide how much of the limb needs to be removed. Muscles and skin will be formed around the remaining bone so that an artificial limb can be used.

Hip replacement

A hip replacement, or arthroplasty, is a surgery performed to remove a diseased or damaged hip joint and replace it with an artificial joint. Conditions such as osteoarthritis, rheumatoid arthritis and osteonecrosis, as well as bone tumors, fractures or injuries are common causes of hip joint damage. Patients who have cancer that has spread to and damaged the hip joint may be candidates for hip replacement surgery.

Kyphoplasty/vertebroplasty

A minimally invasive procedure, kyphoplasty/vertebroplasty is often used to treat compression fractures of the spinal vertebrae. In this procedure, a special balloon is inflated inside the fractured bone to expand it to its normal height. The balloon is then deflated and removed. Using image guidance, a cement-like material is injected directly into the remaining space through a hollow needle. The material, considered to be as strong as bone, doesn’t injure normal bone tissue. This procedure may help to relieve pain, restore height and mobility, reduce spinal deformity and stabilize fractures.

Limb salvage surgery

Limb salvage surgery, also called limb-sparing surgery, is a procedure intended to remove a tumor while still preserving the nearby tendons, nerves and blood vessels so the patient can maintain function in the affected limb. During the procedure, the surgeon removes the tumor and affected tissue, as well as about one inch of healthy surrounding tissue. If part of a bone is removed during this time, it is replaced, often using synthetic metal rods, prostheses or pieces of bone (grafts). Soft tissue and muscle from other parts of the body are then used to close the wound. Over time, the replacement bone fuses together with the original bone, making limb movement possible. Limb salvage surgery is often used in conjunction with radiation therapy and/or chemotherapy. It may be an option to treat cancer that is spreading at a slow rate.

Orthopedic implants

Patients with primary bone cancers may require orthopedic implants, which are devices that replace or support damaged joints or bones in the body. Pins, rods, screws and plates are the most common implants. Metal rods may be used to prevent bones from breaking. Orthopedic implants are made of plastic, ceramic, stainless steel and titanium. Orthopedic implants may be used to treat joint degeneration in the hip, knee, shoulder and elbow. Implants may restore normal function by increasing mobility and reducing pain.

Surgery is required to secure the implant where it’s needed. Non-surgical methods are often the first line of treatment. Implants are used when non-surgical methods, such as weight loss and physical therapy, do not work. Orthopedic implants wear out after several years, so implants in younger patients may need to be replaced.

Other procedures performed by an orthopedic oncologist may include: