In December 2015, 7-year-old Jorge started to get pain in his knee.

An avid Green Bay Packers fan and aspiring football player himself, Jorge was an active kid, and at first, it didn’t seem out of the ordinary.

But the pain wouldn’t stop.

“Every month, there were emergencies because of the pain. We were told it was inflammation and to go home and ice his knee,” says Jorge’s mother, Alma.

Jorge endured six months of intense knee pain before his doctors discovered sarcoma, a rare type of cancer that can form in the tissue that lines and supports the joints. They referred Jorge to UC Davis Health.

The plan

Jorge’s tumor was inside the soft tissue of his left knee. To help shrink the mass and eliminate the chance of the cancer spreading, he would receive several weeks of chemotherapy. But the process to save the use of his leg would be far more complex.

As part of developing personalized medical solutions, and working in collaboration with Jorge’s parents, a team of oncologists and orthopedic surgeons were brought together to review Jorge’s condition and build a comprehensive recovery plan. To save his life, Jorge needed surgery to remove the cancerous tumor – as well as a significant portion of his leg. As a young boy with dreams of being an athlete, everyone was on a mission to preserve as much of Jorge’s mobility as possible.

Collaboration is central to the mission of the Cancer Center’s Pediatric, Adolescent and Young Adult Sarcoma Clinic, where families work together with oncologists, surgeons, nurse navigators, and physical therapists to get the most optimal care for their child’s individual condition – because no two cancer cases are alike.

“We worked as a multidisciplinary team to solve this,” says pediatric oncologist Marcio Malogolowkin. “Steven Thorpe, his orthopedic surgeon, and I were involved from the very beginning. From patient referral to evaluation to confirmation of diagnosis and start of therapy.”

The goal is for families to get a full assessment from the entire team, so no one ever feels alone or confused during the recovery journey.

I told his family, ‘I hope he’s so physically active he wears the prosthesis out. I love taking care of kids like Jorge. Their resilience always amazes me.—Steven Thorpe, Jorge’s orthopedic surgeon

Discovering healthy

The doctors presented multiple options to Jorge’s family – including amputation of his left leg from the knee down and a custom implant. This was a more standard option for those with sarcoma, but one that would leave Jorge with very little natural mobility.

The most advanced of these options was rotationplasty, an extraordinary procedure to replace his diseased knee with his own healthy ankle – giving him better mobility for a more active life without the need for additional surgeries. Within the Sacramento region, this option is exclusive to the team and capabilities at UC Davis Health. This meant no other cancer center in the region could offer this choice.

With rotationplasty, Jorge’s foot would extend out backward from where his knee would normally be, and a removable prosthetic would then be more easily attachable and have more natural movement. The cosmetic anomaly of an ankle connected to a foot keeps some from making this choice. But for Jorge, reconstruction meant he would get the most natural use of joints, a result that most above-the-knee amputees do not have.

“It was not an easy decision,” says Alma. “But in the end, it was the best option for him.”

Jorge rises again

In November 2016, doctors came together to perform the nearly 12-hour rotationplasty surgery to reconstruct Jorge’s leg.

Jorge could feel his foot immediately and was able to wiggle his toes soon after. He was able to move his new knee within two months of surgery.

Today, Jorge can run, climb, and dive for the football. And his family couldn’t be happier with their decision to reconstruct his leg, which they believe will give him the best chance to live with few physical limitations.

“I told his family, ‘I hope he’s so physically active he wears the prosthesis out,’” says Thorpe. “I love taking care of kids like Jorge. Their resilience always amazes me.”

This year will mark three years cancer-free for Jorge.

“What motivates us to keep moving forward is his smile," says Alma. “Even through things that are really difficult. He always smiles.”