For the first time in Tamil Nadu, Apollo Proton Cancer Centre has successfully conducted a 3D printing technique to save the knee joint and limb of an 8-year-old boy suffering from bone cancer. The family of Master Akhilan from Madurai (Ramanathapuram) approached Apollo Proton Cancer Centre, where he was diagnosed with non-metastatic osteosarcoma of his left proximal tibia.
After evaluation, the patient underwent chemotherapy. The case posed multiple challenges as the tumor was very close to the knee joint but a clear area of 0.5 cm normal bone was present below the knee and hence, the decision was made to attempt surgery and remove the cancerous bone to save his knee joint.
Post-evaluation, he underwent MRI and CT scans to map out the tumor area and decide the best treatment to remove the cancer effectively. Using high quality Dicom imaging, the CT and MRI images were fused to create a 3 dimensional view of the bone containing the tumor. Giving sufficient margins, a 3D printed cutting jig allowed the surgeon pin point accuracy in obtaining the bone cut and saving the native knee joint. Apollo Hospitals has an in-house 3D printing facility and with the use of this novel technology, Apollo Proton Cancer Centre saved a young aspiring cyclist’s knee joint thus saving the growth plate of the knee bone that would allow his bone to grow normally.
In the procedure, the bone containing the tumor was sterilized with a single fraction of radiation to kill the tumor cells and the same bone was re-implanted. Owing to the small piece of bone remaining proximally, a 3D printed customized plate was designed which ensured near perfect reduction and stabilization of the bone.
The use of 3D printing and computer generated images gives the surgeon a renewed perspective of the tumor and allows for more surgical precision. 3D printing is a tool to ensure optimal resection of the tumor while sparing as much normal bone as possible. The lead advantage of this technique is the inherent geometric freedom of technology that allows design of more anatomic shapes thus ensuring accurate fit. With fair pre-planning, this technique helps in reducing intra-operative time as well.
The surgery was performed by experienced team of expert clincians led by Dr. Vishnu Ramanujan, Consultant, Orthopaedic Oncology& Dr RadhakrishnanSatheesan, Senior Consultant- Paediatric Surgeon along with Dr Srinivas Chillukuri, Senior Consultant- Radiation Oncology(Paediatric) at Apollo Proton Cancer Centre in January 2022. The patient is recovering and will be able to ride a bicycle again in few months.
Commenting on the successful surgery, Dr. Vishnu Ramanujam ConsultantOrthopaedic Oncologist said, “It is commendable to witness how technology has advanced and can be a game changer in most critical cancer cases. I have performed multiple surgeries with unpredictable complexities. Such was the case of the young Akhilan but his fighting spirit to live a healthy life was what drove us to do more than our best and help him survive. After the diagnosis of non-metastatic osteosarcoma of his left proximal tibia, we used the method of 3D printing to ensure near perfect reduction and stabilization of the bone during the surgery. With the team of experienced doctors, we were able to complete the surgery successfully. Master Akhilan recovered well and will lead a happy, healthy and cancer free life.”
Sharing his thoughts on the ground-breaking surgery, Dr Rakesh Jalali, Medical Director & Lead- Neuro Oncology, Apollo Proton Cancer Centre, said, “This is the first case of surgery in Tamil Nadu where a 3D printing technique was used, and it has proven to be a testament to our advanced technological treatments. Despite multiple complications, we have been successfully able to cure the non-metastatic osteosarcoma of his left proximal tibia. As we continue to focus our energies towards the betterment of the patients, our motto of rendering ‘Tender Loving Care’ has been yielding positive results, across. We hope that our expertise and technology continues to touch lives and treat cancers effectively and efficiently.”
On the occasion, Mr. Harish Trivedi, Chief Executive Officer Apollo Proton Cancer Centre said, “We, at Apollo Proton Cancer Centre (APCC), are fully committed to give our patients the best treatment to ensure best results. Our hardworking team uses the right expertise and technology at each step of the treatment and makes sure the patient and his/her family is well acquainted with the process and expectations. I am proud of the team and the brave Akhilan for being courageous enough to go through such a tough surgery. We are trying to give him 360-degree care for a healthy and fast recovery.”
Adoption of newer techniques and technologies in the field of Orthopedic Oncology has changed the outlook of cancer treatments and have made it more patient specific and orientated. 3D printing allows the surgeon to visualize the surgical challenge. Custom printed jigs help to accurately carry out the surgical plan and the customized implant allows for exact fit, allowing for excellent immediate and long term stability.
APCC offers specialized 360-degree care with the most advanced technology for complex surgeries. This center has the state of the art units which offer comprehensive cancer care under one roof with a dedicated team of experienced doctors, surgeons, engineers and clinical staff.
