Transformative treatment

Orthopaedic surgeons at Sunnybrook’s Holland Bone and Joint Program are leading the way on innovative procedures that treat serious knee problems while preserving knee joints.

Growing up, Marko Maljukanovic was an active kid who enjoyed basketball, volleyball and track. But by his late teens, Marko noticed a problem with his left leg, which appeared to have a bend in it.

“My knee always hurt,” recalls the dump truck driver from Kitchener, Ont., now 37. By the time Marko was in his early 30s, the pain had become “unbearable,” he says.

Marko’s family doctor referred him to the Holland Bone and Joint Program at Sunnybrook. There, he says, “they couldn’t believe I was still walking on the leg.” Marko was told he was bow-legged on his left side, and diagnosed with osteoarthritis caused by misalignment of his knee.

Fortunately, Marko was a prime candidate for joint preservation osteotomy, a surgical procedure that preserves the patient’s own joint rather than replacing it with an artificial one.

When Marko Maljukanovic first came to Sunnybrook, the team was shocked he was still walking on his leg. Now he’s back on his feet.

This treatment option can be transformative for people with early to mid-stage arthritic disease that is affecting their quality of life, says Dr. Sebastian Tomescu. Dr. Tomescu and Dr. David Wasserstein are the two orthopaedic surgeons at Sunnybrook specializing in joint preservation surgery.

Dr. Tomescu explains that orthopaedic surgeons mostly avoid joint replacement in younger patients for two reasons: it can limit their ability to take part in high-impact activities and the artificial joint might wear out as the patient gets older. He adds that a person’s native joint always functions better than a prosthesis.

On March 16, 2021, Dr. Tomescu performed a double osteotomy on Marko’s leg. Osteotomy is one of an emerging array of highly specialized joint-preservation procedures designed to correct alignment and decrease the load on the arthritic portion of the joint.

Most osteotomies performed so far at the Holland Centre have involved the knee, but Sunnybrook plans to expand to the hip.

Twelve weeks after his joint preservation surgery, Marko says he is able to walk without crutches or a cane. “I’m more mobile now than I was with the bad leg,” he adds. “I think the doctor and his team did a great job. Every week, my leg’s getting better.”