Rotationplasty for limb salvage in the treatment of malignant tumors at the knee. A follow-up study of seventy patients.

Gottsauner‐Wolf, Florian; Kotz, R.; Knahr, K.; Kristen, H.; Ritschl, Peter; Salzer, M.

doi:10.2106/00004623-199173090-00012

Cited by 118 publications

(76 citation statements)

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“…Rotationplasty [10] gives excellent functional success in children [16] but has a very low patient acceptability [13]. Resection arthrodesis achieves excellent stability but has the major drawback of lack of knee motion [2].…”

Section: Discussionmentioning

confidence: 99%

Custom megaprosthetic replacement for proximal tibial tumours

Natarajan

Sivaseelam²,

Rajkumar

et al. 2003

International Orthopaedics

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We analysed 133 patients treated with resection and endoprosthetic proximal tibial replacement from 1988 to 2000. Mean age was 22.3 years and osteosarcoma was the most common tumour. Average follow-up was 59.4 months. An excellent functional result was achieved in 63 patients and a good result in 36. The number of patients who had no evidence of disease was 102. Twenty-four patients died due to disease. Infection was the most common complication, followed by periprosthetic fracture and aseptic loosening. The 5-year limb survival rate was 85.5%.Résumé Nous avons analysé 133 malades, traités par ré-section et remplacement endoprothétique du tibia proximal de 1988 à 2000. L'âge moyen était 22.3 ans et l'ostéosarcome était la tumeur la plus fréquente. Le délai moyen de suivi était 59.4 mois. Un excellent résultat fonctionnel a été obtenu pour 63 malades et un bon ré-sultat pour 36. Le nombre de malades qui n'avaient pas de signe de maladie était 102. Vingt-quatre malades sont morts à cause de la maladie. L'infection était la complication la plus fréquente, suivi par les fractures péripro-thétiques et le descellement aseptique. La présence du membre à 5 ans était de 85.5%.

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Section: Discussionmentioning

confidence: 99%

Custom megaprosthetic replacement for proximal tibial tumours

Natarajan

Sivaseelam²,

Rajkumar

et al. 2003

International Orthopaedics

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“…Vascular anastomosis has been suggested as a risk factor for vascular compromise as a result of potential for anastomosis failure [12]. In our study, 20 patients (80%) had resection of the femoral vessels, with successful anastomosis of the femoral artery and vein to the popliteal vessels in 17 of them.…”

Section: Discussionmentioning

confidence: 72%

“…Postoperative complications, especially vascular compromise, may be devastating and, in the worst scenario, patients require amputation for ischemia [2,12,17]. A recent study reported two amputations for unsalvageable arterial compromise out of 30 patients [2].…”

Section: Introductionmentioning

confidence: 99%

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Complications and Risk Factors for Failure of Rotationplasty: Review of 25 Patients

Sawamura

Hornicek

Gebhardt

2008

Clinical Orthopaedics &Amp; Related Research

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Rotationplasty is one treatment option for femoral bone sarcomas in skeletally immature patients. This procedure enables patients to avoid phantom pain, limb length discrepancy, or loosening of an endoprosthesis, and good functional outcome has been reported. However, rotationplasty is only rarely indicated and the surgical complications or risk factors for failure of the procedure that might influence choices of treatment or patient counseling have not been well described. We reviewed 25 patients who underwent rotationplasty focusing on risk factors for failure and postoperative complications. Three of 25 patients had vascular compromise resulting in amputation. All three had vascular anastomosis and were resistant to chemotherapy with less than 95% of tumor necrosis. Two of the three patients who underwent amputation had a pathologic fracture before surgery. Late complications included one patient with a tibial fracture, two with wound complications treated with skin grafts, one with nonunion,

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“…However, numerous complications have been reported with this procedure, including nonunion, malunion, local recurrence, compartment syndrome, superficial infection, and deep infection [2,6,9,13,19]. One of the most serious potential complications involves vascular compromise of the reconstructed limb [11, 17, 20-22, 27, 32, 33].…”

Section: Introductionmentioning

confidence: 99%

Vascular Management in Rotationplasty

Mahoney

Hartman

Simon

et al. 2008

Clinical Orthopaedics &Amp; Related Research

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The Van Nes rotationplasty is a useful limbpreserving procedure for skeletally immature patients with distal femoral or proximal tibial malignancy. The vascular supply to the lower limb either must be maintained and rotated or transected and reanastomosed. We asked whether there would be any difference in the ankle brachial index or complication rate for the two methods of vascular management. Vessels were resected with the tumor in seven patients and preserved and rotated in nine patients. One amputation occurred in the group in which the vessels were preserved. Four patients died secondary to metastatic disease diagnosed preoperatively. The most recent ankle brachial indices were 0.96 and 0.82 for the posterior tibial and dorsalis pedis arteries, respectively, in the reconstructed group. The ankle brachial indices were 0.98 and 0.96 for the posterior tibial and dorsalis pedis arteries, respectively, in the rotated group. Outcomes appear similar using both methods of vascular management and one should not hesitate to perform an en bloc resection when there is a question of vascular involvement. Level of Evidence: Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

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Rotationplasty for limb salvage in the treatment of malignant tumors at the knee. A follow-up study of seventy patients.

Cited by 118 publications

References 0 publications

Custom megaprosthetic replacement for proximal tibial tumours

Custom megaprosthetic replacement for proximal tibial tumours

Complications and Risk Factors for Failure of Rotationplasty: Review of 25 Patients

Vascular Management in Rotationplasty

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