Two years ago, a patient presented with complaints of pain in the hip joint, which had worsened after a bout of COVID-19. At her daughter's insistence, she was granted a quota for hip replacement surgery.
During the pre-operative examination, an ultrasound incidentally revealed a bladder tumor. Further diagnostics by oncourologists confirmed the diagnosis: non-invasive bladder cancer (the tumor affected only the mucous membrane, without growing into the muscle layer, but was significant in size).
In November 2023, the patient underwent transurethral resection (TUR) of the tumor followed by a course of intravesical chemotherapy. However, during the treatment, after the fourth procedure, the function of the right kidney declined, requiring the placement of a nephrostomy tube. The chemotherapy also led to a reduction in bladder volume. After a year and a half, the cancer recurred, and a TUR procedure was performed again.
Despite the oncological disease, the oncologists insisted on joint replacement to enable further treatment of the underlying condition and to improve the patient's quality of life. The surgery was considered high-risk due to the patient's age, oncological history, and concomitant severe osteoporosis, where bone tissue has critically low density.
The Department of Traumatology and Orthopedics at the NMRC for Hematology, under the direction of Vasily Mamonov, Cand. Med. Sci., agreed to take on these risks and perform the intervention. The surgery was performed by trauma-orthopedic surgeons of the NMRC for Hematology, Ardavazd Vartikyan and Vladislav Nakonechny.
“For patients with oncological diseases and at such an advanced age, any surgery is associated with high risks. However, when the joint surface is already destroyed, the only effective method to relieve pain and restore limb function is endoprosthetics—replacing the joint with an artificial implant. Thanks to thorough preparation, the surgery was successful, and the minimally invasive approach minimized damage to muscles and ligaments, which significantly reduced recovery time and eased rehabilitation,” commented Ardavazd Vartikyan, a trauma-orthopedic surgeon at the NMRC for Hematology.
Now, after rehabilitation, the patient has regained the ability to move freely: to take walks and see her grandchildren more often, which has become her main victory and a return to a full life.
