I wake up, sweating in a hospital bed. The same bed I’ve lain in for days. I was dreaming about riding my bike again, something that I was certain was impossible now. I couldn’t ride a bike with the y-shaped scar over my left hip, a stapled flap hiding the new metal pelvis below.
A couple of weeks earlier I had most of the left side of my pelvis and the top part of my femur removed and replaced with a metal implant. The procedure is known as a ‘massive hemipelvic and proximal femoral replacement’, but I like to call it a ‘hip replacement on steroids’.
“Firstly - and most importantly - we have to do the best we can to treat the cancer by removing the whole tumour”, says my consultant, Mr Will Aston.
“Your operation took about six hours. It was a complicated operation because of the mass of bone we removed. We also had to find all the arteries and nerves and ideally avoid them, or if they were affected we would have had to remove them too.”
As I talk to my consultant, nearly two-years after my operation, I’m struck by how thankful I am for the technological and surgical advances of the last quarter-century. He tells me that the main purpose of cancer surgery is to remove the whole tumour. To provide a good chance of a cure, surgeons like Will often have to remove massive amounts of bone, muscle and soft tissue. Implants allow surgeons to rebuild their patients.
“The prosthetic implant you have,” he tells me. “Is something we call a ‘massive endoprosthetic’, and it really has allowed us to preserve your limb and keep a good function while not compromising the reason we needed to do the operation in the first place - to remove the whole tumour.”
I learn that the prosthetic pelvis I have was custom built, using computer aided design to whittle away at a block of metal. My prosthesis is coated with silver, making it a hip-shaped chunk of ‘bling’. There’s a good reason for this, silver is toxic to bacteria and coating the implant in this way reduces the risk of a serious infection taking hold on the prosthesis. Controlling infection is one of the research breakthroughs that have made fitting these massive prosthetics possible.
“Orthopaedic implant research is all about improving long term outcome and function after limb salvage operations,” says Will. “A big thing we’re now able to do is to 3D-print prosthetics - so they can be built specifically for each patient.”
Two years after being introduced, my custom-built prosthesis has become part of my skeleton - the remaining bone growing into the prosthesis, fixing it in place. Now that I’m able to ride a bike again, I sometimes forget that half of my pelvis is missing. I was curious to learn what advances in orthopaedic research mean for me.
“The first treatment option would have been amputation,” says Will. “You’d have to use an adapted bike to ride. You’d have to use two crutches or a bulky prosthetic limb to walk. Your movement would be much worse and your energy consumption would be much higher, so you’d feel more tired.”
With my high-tech, blinged up implant, I don’t think an observer would be able to tell that half of my pelvis and my left thigh bone are missing. And it’s because of research into orthopaedic implants that I can still ride my bike - something I once thought was impossible.