From Dr. Mark Gebhardt

About a year ago I met a little girl from Puerto Rico who had a malignant bone tumor of her tibia. She was sent to me to excise her tumor after some extensive preoperative chemotherapy. Because she was only 7 at the time, the removal of the tumor below her knee would leave her with a major inequality of the lengths of her leg. Fortunately, there are internal metal prostheses that can replace certain bones (in this case the tibia) and can be “expanded” or lengthened in small increment as the child grows. The expectation is that by the end of growth the two limbs will be equal length. One of the pioneers in this field of prosthesis manufacture and scientific development is a biomechanics laboratory at the Royal National Orthopaedic Hospital in London. The Centre for Biomedical Engineering has become Stanmore Implants Worldwide Ltd, a company that has a specific interest in making custom prostheses for limb salvage following tumor resections. I had them make one for my little patient and it has so far worked beautifully.

While in London, I visited with the bioengineers and technicians at Stanmore to plan the first lengthening for my little patient. It was a morning well spent. I got to tour the facility and see first hand how they computer model the implants and physically make them. I got a demonstration about how the expansion works and planned a trip for them to come to Boston for the first expansion.

I also got to meet the President of the company, Brian Steer, and discussed a research project with their bioengineer Paul Unwin. Their group has developed a specialized technique involving tissue ingrowth into a metal implant that has to potential to augment the way we currently attach artificial limbs to an amputee. A few centers in the US will participate in a pilot study of these implants and this visit provided an excellent venue for them to present their research to me and begin the collaboration.

This is truly an innovative group that maintains a close tie to the University and they are clearly leaders in the field of tumor prostheses. In addition to enhancing the scientific collaborations, they kindly donated funds to the London tour that sponsored a medical student for the trip.