Indications for and surgical complications of rotationplasty

Rotationplasty with Vascular Reconstruction for Prosthetic Knee Joint Infection

“…The most devastating complication after rotationplasty is vascular compromise of the rotated limb, which can result in eventual above-the-knee amputation or hip disarticulation. Although reported rates of vascular compromise after conventional rotationplasty range from 3.7% to 15.4% [ 1 , 2 , 12 ], the rate only after rotationplasty for revision of infected prosthesis has never been reported. In the conventional method of Van Nes rotationplasty, the femoropopliteal artery and vein are preserved with the sciatic nerve, the neurovascular structures are coiled, and the distal limb is rotated axially 180° and reattached to the proximal stump.…”

“…Rotationplasty, in which the distal leg and foot are rotated axially 180 degrees and grafted to the femur to create a functional joint replacing the knee, has been frequently performed as an alternative to above-the-knee amputation for skeletally immature patients after resection of sarcomas of the lower extremity [ 1 – 7 ]. However, rotationplasty can also be performed as a function-preserving salvage procedure for adult patients with infected knee prostheses [ 8 – 11 ].…”

“…Conventional vascular management during rotationplasty is to preserve major vessels and coil them medially with the distal leg, but recently, the utility of transection and reanastomosis of the major vessels has been widely reported ( Figure 1 ) [ 1 , 2 , 12 – 14 ]. However, no consensus has been reached regarding the optimal method of vascular management of rotationplasty after the resection of sarcomas [ 1 , 12 , 13 ]. Furthermore, there has been little discussion regarding the vascular management of rotationplasty for revision of infected prosthetic knee joints [ 1 ].…”

“…However, no consensus has been reached regarding the optimal method of vascular management of rotationplasty after the resection of sarcomas [ 1 , 12 , 13 ]. Furthermore, there has been little discussion regarding the vascular management of rotationplasty for revision of infected prosthetic knee joints [ 1 ].…”

Chronic Osteomyelitis of the Distal Femur Treated with Resection and Delayed Endoprosthetic Reconstruction: A Report of Three Cases

“…If the articular surface is involved, however, these techniques will likely result in arthrodesis of the knee [ 10 – 12 ]. Another surgical option is Van Ness rotationplasty; however, careful patient selection is required for this procedure [ 13 ].…”