Lower Limb Reconstruction & Oncology

Donald S. Garbuz

Sandeep Bhachu
Paul W. Clarkson
Clive P. Duncan
Nelson V. Greidanus
Peter Grunau
Victor Jando

Bassam A. Masri
James A. McEwen (Adjunct)
R.W. McGraw (Emeritus)
Ramin Mehin
Peter L. Munk (Assoc.)
Torsten O. Nielsen (Assoc.)
Kostas P. Panagiotopoulos

Graham C. Pate
Dina Popovic
Arno Smit
Erasmus Smith
Jans Van der Merwe

The Division of Lower Limb Reconstruction & Oncology involves reconstruction of the hip, knee, foot and ankle, as well as treatment of benign and malignant soft tissue and bone tumours.

With the aging population, disorders affecting joints, in particular arthritis, will become more prevalent. For this reason, there will be an increased demand for surgeons who specialize in reconstruction of arthritic joints. We are very fortunate to be providers of such services. Furthermore, we are fortunate in that our results are second to none in terms of medical treatments. The success rate of hip and knee replacements are in the neighborhood of ninety-five percent. Despite this high success rate, these are mechanical devices that tend to fail with time, as all mechanical devices do. Hip and knee replacements tend to last 10 to 15 years, and subsequently they require further revision work. The Division specializes in such revision work, in addition to primary work. The Division also includes the foot and ankle service.

The human foot is a complex structure made up of 26 bones, 107 ligaments and 19 muscles. In addition to treating fractures and dislocations, the orthopaedic surgeon is also concerned with a wide variety of foot and ankle problems (BC Foot & Ankle Specialists: www.bcfootandankle.com) , including abnormalities of the ankle, hindfoot and midfoot; diabetic foot problems; rheumatoid arthritis; and other inflammatory arthritic conditions. A variety of surgical techniques – including joint replacement, arthroscopy, arthrodesis, osteotomy and synovectomy – are used to relieve pain, correct deformities and increase mobility of the joint.

Medical research has a tremendous impact on improving the quality of life for patients with tumours in the bone, cartilage or other tissues of the musculoskeletal system. Not too many years ago, a diagnosis of bone cancer often led to amputation of the affected limb. Today, with the expertise of orthopaedic surgeons and other medical professionals, limb reconstruction surgery – replacing the cancerous area with bone harvested from a healthy part of the body, and/or a bank bone enables the patient to lead a more normal life. In some cases the limb is reconstructed with donated bone or a custom metal implant.

Because of their complex and unique nature, musculoskeletal tumours can be difficult to diagnose and treat. At the weekly Sarcoma Conference held at the British Columbia Cancer Agency, specialized teams of medical professionals from the Departments of Orthopaedics, General Surgery, Radiation and Medical Oncology, Pathology and Radiology meet to review complex cases. The specialists diagnose and determine the best treatment based on the stage of development of the cancer, as well as the patient’s past treatment and personal needs. When surgery is necessary, the operation is often a very lengthy, one-of- a-kind procedure involving several members of the team.