The tennis court was Michelle Smith-Levitin’s happy place. The 14-year-old from Westchester, New York, could play for hours — until one day, she fell and couldn’t put weight on her leg when she stood up.
Tests showed a noncancerous but potentially aggressive growth called a giant cell tumor (GCT) in her proximal tibia (the upper part of the shinbone that connects to the knee). Giant cell tumors usually develop near the knee joint in people 20 to 40 years old. They can be unpredictable and must be surgically removed.
“As a teenager, you don’t have foresight and don’t understand the risks of surgery,” says Dr. Smith-Levitin, now a maternal fetal medicine doctor and mother of two. “I thought they would take it out, I would be in the hospital a few days, and I’d be fine.”
But within two years of the initial surgery, the giant cell tumor returned twice, and each time was bigger and more aggressive, ultimately taking over her entire proximal tibia and impacting the knee joint.
She underwent surgery to replace the affected bone with a bone implant from a cadaver — an experimental treatment at the time that eventually became standard practice.
Dr. Smith-Levitin would go on to have dozens of procedures over the years to address small fractures in her tibia and cysts that developed in the implant, which began to chip away. By age 60, she was facing a serious bone infection and the devastating possibility of having her leg amputated.
When she sought a second opinion at Memorial Sloan Kettering Cancer Center (MSK), something extraordinary became possible: She was offered the chance to become the first person in the world to receive a revolutionary bone implant that could save her leg and her mobility.
Choosing an Expert MSK Orthopedic Surgeon To Help Save Her Leg
“I believed it was possible to save Michelle’s leg,” says MSK orthopedic surgeon Jonathan Forsberg, MD, PhD , a veteran who served in the Navy for more than 30 years. “We could use state-of-the-art technology and materials to custom-design an implant for her that would also help fight her infection. This could be revolutionary, and I was excited about working with Michelle to solve this difficult problem.”
At first, it sounded too good to be true. But by the end of their conversation, she was convinced. “He’s experienced, innovative, and technically amazing. I said, ‘This is no longer a consultation. You’re definitely the guy who’s taking care of me,’ ” she recalls.
Fighting Bone Infection With a Groundbreaking Leg Implant Technology
Dr. Forsberg explained the multistep process. He would remove part of her distal femur (thigh bone) and proximal tibia and replace them with a temporary spacer made of polyetherketoneketone (PEKK), a strong, new material infused with antibacterial properties.
The spacer would be created using a 3D printer to match the exact dimensions of the permanent implant, and it would allow for movement, to preserve knee function while the infection was being treated with continuous intravenous (IV) antibiotics over six weeks.
Dr. Forsberg worked with Onkos Surgical, which makes the Eleos™ Limb Salvage System, to create a permanent implant that would prevent infection long-term and that was based on the unique anatomy of Dr. Smith-Levitin’s leg.
The permanent implant would be coated with NanoCept™ Antibacterial Implant Technology, which was approved by the U.S. Food and Drug Administration (FDA) in April 2024. Dr. Smith-Levitin would become the first patient to receive an implant with the NanoCept™ antibacterial coating.
Back on Her Feet and Getting Stronger Every Day
Two weeks after surgery, her infection was gone, and she “felt a thousand times better,” she says. Two months later, she was able to walk with just a brace on her leg. Her goal is to walk unrestricted, swim, ride a stationary bike, and do Pilates.
“He literally saved my leg!” she says. “I went back to work with some accommodations. I have no more pain, and with physical therapy, I’m getting stronger every day.”