Rambam Health Care Campus is the only Level 1 trauma center in Northern Israel, treating the most difficult, complex injuries. Recently, an exceptionally rare case was treated at Rambam – a large-scale orthopedic injury not seen every day. During an operation in which a multidisciplinary team took part, six procedures were performed to fix an injury that could have led to serious disability.
“We are talking about a young man in his 20s who came to Rambam following a serious knee injury he received in a motorcycle accident,” recalls Dr. Barak Segal, an attending physician in Rambam’s Orthopedic Surgery Unit, who took part in the dramatic surgery. "During a check-up in our imaging department prior to the surgery, it became clear that he was suffering from a very complicated injury. The knee was injured in six different places, each of which required a large and complex operation in its own right. Due to the experience and knowledge accumulated by our team at Rambam, we decided to take the challenge and treat the injuries in one operation."
Large ruptures in the two meniscuses in the knee (the cartilage ligaments), one of which – the medial meniscus – was completely detached, requiring the team to re-implant the meniscus. The second meniscus had a wide rupture, connected in place only by the root attachments to the knee. There were also ruptures in the knee ligaments (front, posterior, and lateral)—and these were only a partial list of the problems resulting from the patient’s serious injury. A surgical team led by Dr. Bezalel Peskin, Head of the Knee and Arthroscopy Unit at Rambam Hospital, and including senior orthopedists Dr. Segal, Dr. Itamar Botser, Dr. Mazen Falah, and Dr. Shadi Sadia, approached the complex task of working together in an operating room filled with interns, operating room staff, nursing staff, anesthesiology staff, and more.
One at a time, the teams operated on the patient, with each team treating different aspects of the patient’s injuries. The doctors performed the surgery using implants taken from a donor and from the patient himself. Three hours later, all injuries were treated successfully. Shortly after the surgery, the young man was released from the hospital, able to move his injured leg without limping.
“I’ve never faced such a complicated injury in the past,” explains Dr. Segal. “From a surgical perspective, these were unusual circumstances, which we succeeded to address in the best possible way for the patient. Instead of making him undergo multiple procedures with complicated recoveries, the surgery was performed once. He is currently undergoing physical therapy and follow-up treatment in order to return to full activity. The surgery was successful thanks to the cooperation between the multidisciplinary teams involved. If he had been treated by a less experienced team, it is definitely possible that this injury could have resulted in disability.”