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Natalia’s Cutting-Edge Endoprosthesis Grows with the Child

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At midsummer this year my daughter Natalia underwent an operation to replace an endoprosthesis in her left leg. Natalia had been diagnosed with Ewing’s Sarcoma nine years ago. She has been in remission for over five years. Her story is part of an ongoing series featured here on Blogcritics, something I plan to develop into a book.

Her surgery this summer was special both for her personally and for the groundbreaking nature of the procedure.

Natalia was chosen to get a new kind of endoprosthesis. For Natalia it was an eagerly anticipated event. The new endoprosthesis would allow her to bend her knee, something she had not been able to do for years with the fixed form of her old endoprothesis.

The story was featured on the documentary show Découverte on RDI, the French-language arm of the national TV channel, CBC, in an episode entitled “Une Prothèse qui Grandit avec l’Enfant,” which translates into English as “the Endoprosthesis that Grows with the Child.”

For those who do not speak French I would like to share a translation of the video since it was a landmark event in Canadian health care.

Early in the video Dr Robert Turcotte, the most respected oncological orthopedic surgeon in Quebec, explains that the rapid growth of the long bones in young children may play a role in their vulnerability to bone cancers such as Ewing’s Sarcoma. In Natalia’s case she was treated with heavy doses of chemotherapy in Poland and almost underwent a complete amputation of her leg. A second opinion and modified amputation allowed her to keep part of her leg with the support of an endoprosthesis that replaced much of the removed femur. In the intervening years her healthy leg had outgrown the endoprosthetic leg by as much as 9 cm.

Dr Turcotte described older models of endoprosthesis that could be mechanically lengthened with periodic surgery; however, the surgery always carried risks of infection. The new endoprosthesis, developed by the London-based company Stanmore, permitted lengthening of the endoprosthesis non-invasively. An engineer and representative of Stanmore, Alec MacKnight, explained the principles of lengthening the leg. This endoprosthesis is among the most advanced available in the world, made of chrome and cobalt, at the cost of $35,000. When placed in a special magnetic field the internal motor turns a gear that lengthens the endoprothesis without the need for surgery.

For Dr Turcotte and the Montreal General Hospital it was a special event, only the second time that the surgery had been performed in Canada.

One of the final scenes shows Natalia undergoing the lengthening of her limb, which involves her sittting in a magnetic field and waiting patiently. Dr Turcotte mentions how each 20 minutes in the magnetic field adds another 5mm to Natalia’s leg. Prior to this remarkable new endoprothesis Natalia had to endure periodic surgeries with all of the problems that accompany it—anaesthetic drugs, wounds, healing, and delayed recovery. Now the procedure is practically harmless. I mean that for Natalia it hardly registers anymore.

What the video, however, does not show is the intensive physiotherapy that Natalia has had to endure and which she continues to undergo to this day. This is where she shows her will. But her therapists are thrilled with her progress and her unrelentlng desire to achieve a maximum range of motion.

I know better than anyone how long she has been waiting for this procedure. She has overcome so many odds and achieved so much. She is the strongest person I have ever met and she is my daughter.

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About Kasia Lanucha