Surgery turns the NYC cancer survivor's ankle into a new knee joint

STONY BROOK, N.Y. –

A 13-year-old cancer survivor from New York is able to dance again, although she has her left leg to the back, thanks to a rare surgery that allowed her to perform a knee joint .

In December 2016, Delaney Unger was diagnosed with osteosarcoma, a rare type of bone cancer, in her distal left femur. Then, in April 2017, Selden's teenager underwent a 13-hour rotoplasty surgery, also called Van Ness procedure, at Stony Brook Hospital.

"I just want to dance again," she said. "Because I've never done anything else other than dancing."

That was the mandate she had given to her doctors in April, and 17 months and a radical surgery later, her dream persists.

Complex surgery removes cancer by surgically amputating the diseased knee, then rotating the lower leg 180 degrees and securing it to the remaining thigh. The foot is turned towards the back and the ankle acts as a new knee.

The main reason for rotationplasty is to improve the mobility of the person as a prosthesis user. Placing the ankle joint in the knee position creates a natural and functional knee, and the toes provide significant sensory feedback to the brain.

Unger said she was not as concerned about the aesthetic issues because amputation below the knee instead of an amputation above the knee is a huge difference in terms of function. Dedicated and versatile dancer, she decided to undergo the operation in the hope of keeping control and mobility in order to lead a full and active life.

"She has to actually recycle her body, retrain her muscles," said Dr. Fazel Khan, assistant professor of osteopathic surgery. "But when she moves her knee now, it's like she's moving her ankle, and that allows us to get rid of cancer completely."

In October 2017, she received a prosthesis on the back foot and stretched up to the thigh. This allowed him to have the driving force to walk, jump, dance and play. She danced in a recital in May 2018, performing lyric, hip hop and jazz songs. Inspired by Stony Brook's doctors, she hopes to become a pediatric oncologist for her future career.

Dr. Khan said that a traditional knee replacement would have prevented Delaney from dancing again. Now this restriction has disappeared. But she had to make some adjustments.

"Usually, if I can not do it the first time, I try it again and practice it at home," she said. "And if I do not have it after a few weeks, then I'm fine, okay, I can not really do that."

Her mother admits that she was skeptical at first, but she now thinks that it was the right decision.

"I was the last to take part in this decision," said Melissa Unger. "But when she turned to me in her hospital bed and said," I would rather have the chance to try something and not be able to try it then, I knew that it was the right choice. "

Delaney will continue to meet with Stony Brook's physicians for follow-up visits over the next five years.

"My daughter has an incredible perspective," said Melissa Unger. "She is very confident, does not hide it and is comfortable and open about it … I also want to thank Stony Brook, the doctors have been there for her. to have exceptional care near us "We did not have to go to town. Stony Brook has everything we need. "