COLUMBUS, Ohio – Two years ago, Dugan Smith, an athletic and active fourth-grader, fell and broke his femur, revealing a softball-sized tumor just above his knee. Now, after undergoing a unique surgery in which his lower leg was amputated, the tumor removed, and the leg rotated and reattached so that his ankle now functions as his knee, Smith, 13, is cancer-free and back to the activities he loves – playing basketball and baseball.
After the shock of learning their son had osteosarcoma, a rare cancer that attacks the bones, his parents opted for the unusual surgical procedure to increase his chance not only of survival, but to help him return to an active lifestyle. Fewer than 12 rotationplasty surgeries are performed each year in the United States.
“For an active child, the rotationplasty surgery can be the best option,” said Dr. Joel Mayerson, Smith’s orthopaedic oncologist at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richad J. Solove Research Institute. “The fact that he is out playing baseball and living his life like a normal teen-ager, speaks to the success of the surgery and his determination to overcome all odds to do something he truly loves.”
The rotationplasty procedure allows doctors to remove the diseased portion of the patient’s leg, in Smith’s case, the middle section including his knee. The lower leg is turned backwards and reattached to the area just above where the tumor had been removed. By rotating the leg, Smith’s calf muscle now serves as his thigh, while his ankle and foot act as his knee and shin. He has been fitted with a prosthetic leg that fits over his foot and ankle, allowing him to walk, run and play sports. Smith is now the star pitcher of his middle school baseball team in Fostoria, Ohio.
“Unlike adults, children can re-train their body to make their foot work like a knee, enabling them to run and participate in athletic activities,” said Mayerson, who is one of only 125 fellowship-trained musculoskeletal oncologists nationwide. “Having this procedure also eliminates the need for follow-up surgeries as the child continues to grow, because the bone will grow on its own as the child ages, and there aren’t any artificial parts to break or become damaged with wear.”
Mayerson is also on staff at Nationwide Children's Hospital where Smith's surgery was performed. While the procedure is rare and may be considered extreme, research shows that patients report a high level of quality of life and psychological satisfaction.
The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (cancer.osu.edu) is one of only 40 Comprehensive Cancer Centers in the United States designated by the National Cancer Institute. Ranked by U.S. News & World Report among the top cancer hospitals in the nation, The James is the 205-bed adult patient-care component of the cancer program at The Ohio State University. The OSUCCC – James is one of only five centers in the country funded by the NCI to conduct both phase I and phase II clinical trials.# # #
Medical Center Public Affairs and Media Relations