In a South African first, a surgeon based in Centurion has successfully performed a groundbreaking hip and limb-salvage operation using a liquid nitrogen-dipping technique, potentially opening new treatment options for patients with certain orthopaedic cancers.

The complex procedure was carried out this week at Netcare Unitas Hospital, where a 15-year-old boy diagnosed with Ewing’s sarcoma – an aggressive bone cancer – underwent surgery that saved his leg.

First time in SA

Orthopaedic surgeon, Dr Jaco Viljoen, who led the operation, said conventional treatment would have required removing the diseased section of bone and replacing it with a large prosthesis. This solution would likely have ended the teenager’s hopes of returning to contact sport.

“When I explained that conventional surgery meant no more contact sports, I saw the devastation in his eyes – and in his father’s. That’s when I knew we had to try something different,” Viljoen said in a statement issued by Netcare Unitas Hospital.

During the four-and-a-half-hour operation, surgeons removed a 24-centimetre section of the boy’s femur where the cancer had developed.

The bone segment was then immersed in liquid nitrogen at -179°C to destroy cancer cells, then reimplanted and secured.

According to the hospital, the surgical team has performed the technique for the first time in South Africa.

Viljoen said the procedure was inspired by a method developed in Japan more than a decade ago, but one that is still rarely used internationally, particularly in patients with Ewing’s sarcoma.

“We’ve effectively preserved his bone and hip joint. His own bone will regenerate and integrate with the surrounding tissue. For a young person, that’s game-changing, as his leg can continue to develop normally,” he said.

He added that the technique could offer hope to other suitable patients who might otherwise face amputation or highly invasive reconstructive surgery.

Encouraging signs

Ewing’s sarcoma is the second most common bone tumour affecting children and adolescents. It primarily affects people aged 10 to 20 and most often develops in the long bones of the arms and legs, as well as the pelvis and chest wall.

Viljoen said the patient was showing encouraging signs of recovery.

“A day after surgery, the patient was alert and showed good neurovascular function in the affected leg. He even managed a few assisted steps with his physiotherapist,” he said.

The surgical team included assistants Dr Jadine Du Plessis and Dr Herman Breet, anaesthetist Dr Bianca Brits, and theatre nursing staff Gloria Kgwete, Leah Lekoane, and Mahlatse Motheta.

Dr Erich Bock said the operation demonstrated that world-class orthopaedic care was available in South Africa.

“This is about more than innovation – it’s proof that world-class orthopaedic care happens right here at home, offering hope to patients facing life-altering conditions,” Bock said.

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