Limb-Sparing Surgery for Bone Cancer Starts with Proper Biopsy

Johns Hopkins Orthopaedic Surgery
December 10, 2014

Small things like how a biopsy is done can make a huge difference in the type of surgery that can be offered for these patients.

People are living longer with cancer thanks to systemic control of cancer with newer chemotherapeutic drugs and targeted therapies and because of that, patients are developing new problems,” says Johns Hopkins orthopaedic oncologist Carol Morris.

Primary bone cancer and metastatic cancer to bone represent a small but growing challenge in orthopaedics. Morris works with a team at The Johns Hopkins Hospital that treats patients quickly and effectively. The team includes orthopaedic oncologists, general surgical oncologists, radiation oncologists, adult medical oncologists, interventional musculoskeletal radiologists, sarcoma pathologists, plastic surgeons, neurosurgeons and urologists with specific expertise in orthopaedic oncology.

When patients begin their treatment with a biopsy by an orthopaedic oncologist, Morris says they are likely to have better outcomes. “Small things like how a biopsy is done can make a huge difference in the type of surgery that can be offered for these patients,” she says. “The operations involve removing parts or entire bones and replacing them with allograft or large prostheses. If the biopsy technique is incorrect, it can compromise the operation and lead to sacrificing more bone than muscle and even amputation in rare instances.”

All of the specialties needed for a successful limb-sparing operation are located in one place at Johns Hopkins so patients do not have to travel to see various specialists. For example, plastic surgeons are on site for soft tissue coverage and vascularized bone grafts; neurosurgeons are available for nerve and muscle transplants. During the initial consultation, patients can usually see all of the physicians related to their care in a single visit.

The Johns Hopkins team devises unique limb-sparing surgeries that are as durable and functional as possible. “For metastatic bone disease, we aim to provide the right balance of treatment and palliative support to allow patients to have the best quality of life possible,” Morris says. “For primary tumors, we focus on not just removing tumors, but rebuilding the affected limb to maximize functionality and longevity.”