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YOUR HEALTH: Creating the 'Super Knee'

Surgeries helped a nine-year-old girl avoid leg amputation.

NEW YORK CITY, N.Y. — It's like fixing what was once unfixable.

For years, there has been little doctors could do to help children with a rare condition that causes babies to be born without a bone in one or both of their lower legs.

Now, a New York orthopedic team is using a series of surgeries that creates stability so kids can be kids. It helped Leila Ricks who loves to dance, hip-hop and TikToks. She's come a long way in the past year. 

Leila was born without a fibula bone in her leg so, they were two different lengths and her foot was out of place.

"I couldn't keep my legs straight, like flat, because if I was, my ankle would be all the way down here, my hip would be all the way down here, and I would be like a fashion model," she explained.

For some kids with this rare disorder, amputation is sometimes the option. 

Instead, pediatric orthopedic surgeons at Mount Sinai Health System mapped out a series of surgeries for Leila. 

They started with a leg-lengthening procedure, breaking the tibia bone in her right leg and attaching a frame to carefully stretch it.

"My husband and I would have to turn it according to the prescription that they gave us," said Leila's mother Kei.

"We would have to turn the rods and the rods would push the bone farther apart."

It was tough for Leila, an active little girl who was confined to a wheelchair and then a walker for eight months as she recovered.

But surgeons had even more challenges before Leila could better recover.

Leila was also missing two knee ligaments, her ACL and PCL, so after leg lengthening, doctors performed what they called a SUPERknee surgery.

"We used her own soft tissue on the outer side of the leg and rerouted it through the knee in order to reconstruct both of those ligaments," said Dr. Sheena Ranade, a pediatric orthopedic surgeon.

Right now, Leila's happy to be getting around and playing with her puppy, Macy.

"So, now, I'm confident because my doctor said I can do stuff now." 

Doctors say it's likely that Leila may have more surgery in the future. 

In addition to another limb lengthening surgery, doctors may also perform what they call a SUPERankle procedure, which would help them stabilize her ankle.

The SUPER knee procedure

This surgery is just one lateral incision and uses already existing ligaments to help strengthen that person's leg. 

It is commonly combined with SUPERhip, which is a combination of surgeries to correct severe deformities in someone's bone and soft tissue. 

SUPER is an acronym for Systematic Utilitarian Procedure for Extremity Reconstitution. This procedure aims to realign the kneecap, correct flexion contracture, and missing ligaments, such as ACL and PCL. 

At the end of the procedure, the patient is required to have internal wires to pin the knee for six weeks to keep the leg straight. 

After that time, the wires are removed, and they move on to the next step.

Each procedure has the same steps, but those steps are customized to the patient. 

The SUPER knee procedure was created in 1995 by Dr. Dror Paley

He also invented the SUPER hip procedure in 1997.

The surgery's effectiveness

The SUPER knee along with its sister surgeries, the SUPER hip and ankle, have helped so many different people of all ages. 

In a meta-analysis done in 2020, 211 patients with fibular hemimelia were reviewed with 120 of them undergoing amputation and the other 91 undergoing limb reconstruction. 

It was discovered that there was a bigger satisfaction with the limb reconstruction then there was with amputation because of the reconstruction techniques that have been reinverted to correct the deformities. 

If this story has impacted your life or prompted you or someone you know to seek or change treatments, please let us know by contacting Jim Mertens at jim.mertens@wqad.com or Marjorie Bekaert Thomas at mthomas@ivanhoe.com.