Netcare Unitas performs South Africa’s first liquid nitrogen bone-freezing surgery

SOUTH AFRICA—Netcare Unitas Hospital has conducted South Africa’s first hip and limb-salvage operation using a liquid nitrogen bone-freezing technique, creating a potential new treatment pathway for selected patients with orthopaedic cancers.

The landmark surgery took place this week at the hospital in Centurion, where a 15-year-old boy diagnosed with Ewing’s sarcoma, an aggressive form of bone cancer, underwent a procedure that preserved his leg and hip joint.

Teenager faces life-changing diagnosis

The patient had developed cancer in a large section of his femur, the thigh bone.

Standard treatment in such cases often involves removing the affected bone and replacing it with a major prosthetic implant.

While that option can be effective, it may limit mobility and usually rules out participation in high-impact or contact sports in the future.

Orthopaedic surgeon Dr Jaco Viljoen, who led the operation, said the emotional impact of the conventional treatment plan was clear when he discussed it with the teenager and his family.

He explained that once he saw how deeply the news affected both the boy and his father, he felt compelled to explore an alternative that could preserve the young patient’s future quality of life.

How the procedure worked

During the four-and-a-half-hour surgery, the medical team removed a 24-centimetre section of the femur where the tumour had formed.

Instead of discarding the bone, surgeons treated it by immersing it in liquid nitrogen at -179°C (-290°F), a process designed to kill remaining cancer cells.

After freezing the bone segment, the team reimplanted it into the patient’s leg and secured it in place.

Because the patient keeps his own bone rather than receiving an artificial replacement, doctors expect the tissue to gradually heal and reconnect naturally with surrounding bone and muscle.

Viljoen said preserving the patient’s own hip joint and bone structure was especially important because the teenager is still growing.

He added that the reconstructed leg can continue to develop more normally than it would with some conventional prosthetic solutions.

Rarely used technique gains ground

According to Netcare Unitas Hospital, this was the first time the liquid nitrogen-dipping method had been used in South Africa.

The technique was originally developed in Japan more than a decade ago, but hospitals worldwide still use it sparingly, particularly for patients with Ewing’s sarcoma.

Doctors say the approach may benefit carefully selected patients who would otherwise face amputation or highly complex reconstructive surgery.

Ewing’s sarcoma is the second most common bone tumour in children and adolescents.

It most often affects people between the ages of 10 and 20 and usually develops in the long bones of the arms and legs, as well as the pelvis or chest wall.

Early recovery signs are encouraging

Viljoen reported that the teenager showed promising signs soon after surgery.

By the next day, he was alert, had good blood flow and nerve function in the affected leg, and managed a few assisted steps with the help of a physiotherapist.

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

Expanding advanced cancer care in South Africa

Dr Erich Bock said the operation highlighted the level of specialist orthopaedic treatment available locally.

He noted that South African patients facing serious and life-changing conditions can now access advanced procedures without traveling abroad.