This type of surgery means removing the cancer without having to remove the arm or the leg (amputation). It involves removing all of the tumour from a limb, including any bone and muscle which is affected by the tumour. The bone is usually then replaced with a specially designed metal implant called an 'endoprosthesis' or with bone from another part of your body, which is called a bone graft.
before the op
If you've had chemotherapy, you'll need a bit of time for your body to recover before you have the surgery. This will probably take 2 or 3 weeks from your last chemotherapy treatment. Doctors will check that your blood count has returned to normal. They'll also make sure that you're well enough to have the operation. For example, you may have lost weight or been off your food a bit while on chemo, so you might need to build yourself up a little before the op. The hospital dietitian can help with this.
Before the surgery, you may also see a physiotherapist who will give you exercises to strengthen your muscles. If you want to see what the replacement implant (endoprosthesis) looks like, the nurses or medical staff might be able to arrange this.
immediately after the op
After the op, your limb will be bandaged or you might have a splint in place. This is to keep it still so that the tissues around the implant can heal.
It's likely that you'll have a 'drain' in place. This is a tube in your wound that allows fluid to drain into a small plastic bottle. This is usually removed after a day or so.
A 'drip' will give fluids into a vein in your arm until you can eat and drink properly again.
It's likely that you'll have some pain and discomfort after your surgery. You'll be given strong painkillers (in injection form at first). The pain usually gets better within 2 or 3 days of surgery. You must let the nurses know if at any time you need extra pain relief. Gradually you'll need less strong painkillers and the pain will reduce.
what will I be able to do?
Because there are so many different types of tumour that can be in different places in your body, it is difficult to give general information on what you will be able to do afterwards. The best person to ask is your surgeon. Although limb-sparing surgery allows you to keep your arm or leg, it does involve removing bone and muscle and so usually the limb does not work as well as it used to. For example, if you have surgery to your leg, you might be left with a limp or find it difficult to run afterwards. You might find that walking is a bit uncomfortable at first, but your physio will give advice and support.
Knee joint replacement
With a knee joint replacement, you will be able to walk and swim OK, but you’ll usually be advised not to run or play contact sports, as these activities can wear the artificial joint out or cause it to work loose. It’s usually OK if you need to run a short distance for a bus or something, but the general view is that running or jogging wears out the knee replacement and so is best avoided. If it wears out or loosens, you might need to have the knee joint replaced after a few years, although these days, the artificial joints that are used are longer lasting.
Hip joint replacements
Hip joint replacements usually work really well and you should be able to carry out normal activities, although as for knee replacements, usually you would be advised to avoid running or contact sports. About 1 in 10 people need another op within 10 years to replace the hip (as it can work itself loose).
Shoulder replacement
If you have a shoulder replacement, you will be able to move your arm around normally below shoulder height, but might not be able to lift your arm above your shoulder.
Bone graft
If your surgery is a bone graft onto a straight part of bone, your surgeon will give you advice about what to look out for and will give you an idea of how well the limb is likely to work afterwards. If you are still growing, you'll need to have further surgery to lengthen your affected limb as your other arm or leg grows. Some new implants can be made to grow as you do without any further operations.
