Radical resection of tumor, femur or knee
CPT4 code
Name of the Procedure:
Radical Resection of Tumor, Femur or Knee
Summary
Radical resection of a tumor in the femur or knee is a surgical procedure to remove a tumor located in or around the thigh bone (femur) or knee joint. This operation aims to excise the tumor entirely, along with some surrounding healthy tissue to ensure no cancer cells remain.
Purpose
The procedure addresses tumors, both benign and malignant, localized in the femur or knee area. The primary goals are to eradicate the tumor, relieve pain, preserve as much function as possible, and prevent the spread of cancer if the tumor is malignant.
Indications
- Presence of a malignant (cancerous) or benign (non-cancerous but problematic) tumor in the femur or knee
- Symptoms such as persistent pain, swelling, or dysfunctional mobility in the affected area
- Failed response to other treatment methods like chemotherapy or radiation
- Tumors that are at risk of fracturing the bone
Preparation
- Preoperative fasting typically required for at least 8 hours
- Cease certain medications like blood thinners as advised by the doctor
- Undergo diagnostic tests such as MRI, CT scans, and bone scans
- Routine blood work and medical clearance
Procedure Description
- The patient will receive general anesthesia to ensure they are asleep and comfortable.
- Surgeons make an incision over the site of the tumor.
- Specialized surgical tools are used to remove the tumor and a margin of surrounding healthy tissue.
- If necessary, reconstructive techniques like bone grafts or metal implants may be employed to stabilize the residual bone structure.
- The incision is then closed with sutures or staples, and a sterile dressing is applied.
Duration
The procedure typically takes anywhere from 2 to 4 hours, depending on the complexity and extent of the tumor.
Setting
The procedure is performed in a hospital operating room.
Personnel
- Orthopedic or oncologic surgeons
- Surgical nurses
- Anesthesiologists
- Radiologists and other support staff
Risks and Complications
- Infection
- Blood loss
- Blood clots
- Damage to nearby nerves or blood vessels
- Fracture of the bone
- Recurrence of the tumor
- Complications from anesthesia
Benefits
- Removal of the tumor, eliminating or significantly reducing the cancer
- Relief of pain and improvement of function
- Prevention of tumor spread in the case of malignancy
- Improved quality of life
Recovery
- Hospital stay ranging from a few days to a week
- Pain management with medications
- Physical therapy to restore mobility and strength
- Follow-up appointments for wound care and to monitor recovery
- Restrictions on weight-bearing activities and gradual reintroduction of normal activities over weeks to months
Alternatives
- Chemotherapy or radiation therapy
- Limb-sparing surgery
- Joint replacement, in cases involving the knee
- Amputation in severe cases
Pros and Cons:
- Chemotherapy/radiation may not fully eliminate the tumor but can shrink it
- Limb-sparing surgeries and joint replacements maintain limb functionality but might not be as effective against certain aggressive tumors
- Amputation eliminates the tumor effectively but at the cost of limb loss
Patient Experience
Patients can expect to experience significant discomfort and pain post-operation, which is managed through pain relief medications. Swelling and bruising around the surgical site are common. Physical rehabilitation is crucial and often challenging, requiring consistent effort and sessions with physical therapists. Most patients gradually regain function and strength with appropriate care and rehabilitation plans.