New Delhi: Naida Khatoon's right knee was acting up. For the past six months, this 21-year-old resident of Baghpat
in Uttar Pradesh was experiencing bouts of excruciating pain, interspersed with numbness of the right leg. Naida's mobility was reduced and her knee started to swell. She was then rushed to All India Institute of Medical Sciences where the bad news followed.
MRI scans and biopsy confirmed that Naida was suffering from
advanced cancer of the patella (the bone forming the knee cap which is vital for mobility of the knee joint), an extremely rare condition. Facing lifelong disability, Nadia would normally have had to choose between two harrowing options: walk with the help of a calliper all her life or never be able to bend her knee.
But in a landmark surgery, done for the first time in the world, a team of orthopaedic surgeons from AIIMS removed Naida's entire knee cap, tendons and part of the shin bone to replace it with corresponding parts donated by a 52-year-old woman doctor who died in January this year.
"This is a first time that such a surgery has been attempted and done successfully. In such cases, doctors scrape away the cancer from the knee cap in order to try and retain the patient's own patella. This leads to a recurrence of the cancer. But Naida runs no such risk because she has a brand new patella and patellar tendon,'' said Dr Rajesh Malhotra, professor of orthopaedics, AIIMS.
Most of these cases were treated by either curettage (removal of tumour while preserving most of original bone), patellectomy (removal of the bone forming the knee cap) by fusion of knee joint or even amputation. "The priority was to remove the cancerous knee cap with a wide margin to ensure complete cure from cancer. But the removal of the tumour would have left her with a non-existent knee cap and tendon and subsequent lifelong deformity,'' Dr Malhotra said.
Using substitute parts available in the institute's bone bank, donated by a 52-year-old doctor who died in January, the team decided to carry out the reconstruction surgery.
BONE of the Matter
Only 400 cases of cancer of the patella (kneecap) reported in the last century
World's first replacement of entire kneecap, tendons and shin bone
21-yr-old got the bones of a 52-yr-old donor