A 22-year-old woman with thigh pain was diagnosed with osteosarcoma. Taipei Rongzong's "Osteotomy-free In-situ Freezing" helps save her limbs

2026/09/23 17:07

When Ms. Wang was 22 years old, she sought medical treatment for pain in her right thigh that lasted for more than 2 months. She was diagnosed with malignant osteosarcoma and received Beirong osteotomy-free in-situ cryotherapy. (Photo by reporter Hou Jiayu)

[Reporter Hou Jiayu/Taipei Report] The thigh pain turned out to be osteosarcoma! At that time, 22-year-old Ms. Wang suffered from thigh pain for more than 2 months and was diagnosed with malignant osteosarcoma. She received chemotherapy and Taipei Wing General’s “osteotomy-free in-situ freezing” technique to save her limb. It has been more than 5 years since the operation. He had lung metastasis but had undergone surgical resection. He is currently following up and living a healthy life.

Wu Bogui, director of the Joint Reconstruction Department of Beirong Orthopedics Department, said that the treatment of osteosarcoma cannot rely solely on surgery. It usually requires more than 2 months of preoperative chemotherapy, followed by extensive tumor resection and bone reconstruction, and postoperative chemotherapy for about 6 to 8 months. In addition to completely removing the malignant tumor and a certain range of surrounding normal tissue to avoid residual tumor cells, surgery must also immediately deal with the large-scale bone defect left after the resection, so as to preserve the patient's ability to stand, walk and move as much as possible.

At present, there are two main directions for reconstruction of large bone defects: tumor-based artificial joints and biological reconstruction. Artificial joints use metal artificial joints and implants to replace the removed bones, but they may still face problems such as loosening of the artificial joints in the long term. Biological reconstruction involves specially treating the tumor bone to kill cancer cells, and then putting the original bone back into the patient's body.

Among them, liquid nitrogen freezing is one of the biological reconstruction methods. The traditional method requires that the tumor-containing bone be completely cut off, taken out of the body, and then frozen in liquid nitrogen at minus 196 degrees Celsius for about 20 minutes. After warming, it is put back in place and fixed with a steel plate. Wu Bogui pointed out that after traditional osteotomy and reconstruction, the bones take an average of about 10 months to heal. During this period, patients may need to use crutches for a long time, and problems such as bone non-healing may occur, which affects muscle strength and functional recovery.

In order to reduce the burden caused by osteotomy, Beirong has developed "osteotomy-free in-situ freezing" biological reconstruction technology. The biggest feature is that the entire bone does not need to be completely cut off. Instead, the liquid nitrogen freezing process is completed directly in the body while the bone is still connected to the body, and the original bone structure is preserved. Wu Bogui said that if the patient's conditions are suitable, he can get out of bed as soon as the next day after the operation. Some patients even only need to use crutches for 1 or 2 days. Compared with the traditional method, which takes about 10 months on average, functional recovery is expected to be faster. In addition, the surgery can also save the time of bone removal, re-positioning and plate fixation, which can be shortened by nearly 2 hours on average.

However, this technology is not suitable for everyone. Wu Bogui pointed out that the key is that the bone structure should remain intact after tumor resection. If the tumor has destroyed and hollowed out the bone, and the structure is insufficient to support it, it is less suitable to directly use in-situ freezing. The medical team may instead use artificial joints or use donated bones from a bone bank for reconstruction.

One of the biggest challenges in this surgery is how to avoid the hypothermia of liquid nitrogen from damaging surrounding normal soft tissues. Wu Bogui said that the temperature of liquid nitrogen reaches minus 196 degrees Celsius. During the freezing process, the bones must be carefully separated from the surrounding soft tissues, and surgical techniques, gloves and gauze should be used as isolation to avoid frostbite.

Looking back on the treatment at that time, Ms. Wang said that at first it was just pain in her right thigh. Unexpectedly, a tumor was found during the examination. After the diagnosis, she had to face chemotherapy and surgery. She felt helpless because of fear of hair loss, loss of physical strength and side effects of treatment. She was hospitalized many times during chemotherapy, and the pain was so painful that it was difficult to walk normally. However, with the support of her family, friends and medical team, she still managed to survive the treatment step by step.

Wu Bogui reminded that there are about 120 cases of primary malignant bone tumors in Taiwan every year. Osteosarcoma mostly occurs in middle school and high school students, and may also occur in people in their 20s and 30s. There are usually no clear life risk factors such as smoking and drinking. Long-term follow-up is still required to detect local recurrence or distant metastasis early.

Ms. Wang originally loved dancing and sports, and the medical team tried to preserve the function of her limbs and joints as much as possible during treatment. (Photo by reporter Hou Jiayu)