Rotationplasty--quality of life after 10 years in 22 patients

Rödl, Robert; Pohlmann, Ursula; Gosheger, Georg; Lindner, Norbert; Winkelmann, Winfried

doi:10.1080/000164702317281468

Cited by 66 publications

(41 citation statements)

References 18 publications

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“…Several studies have documented good functional outcomes after rotationplasty, in patients with with followup as long as a mean of 8 years after surgery, and who were evaluated clinically by means of the Musculoskeletal Tumor Society (MSTS) score and other measures [1, 10-18, 22, 24], and instrumentally by means of gait analysis [5,8,15,22,26]. After rotationplasty, patients were observed to have fewer restrictions for daily activities and sport exercises, even at a competitive level [17,24], and for hobbies compared with patients with endoprostheses [14]. The mid-and long-term quality of life and social relationships of patients after rotationplasty are comparable to those of the general population [28].…”

Section: Introductionmentioning

confidence: 99%

How Much Clinical and Functional Impairment do Children Treated With Knee Rotationplasty Experience in Adulthood?

Benedetti

Okita

Recubini

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Rotationplasty may be indicated for some children with osteosarcoma in the distal femur or proximal tibia; in properly selected patients, it may offer functional advantages over transfemoral amputation and more durable results than a prosthesis. The clinical and functional outcomes reported for this procedure generally have been limited to studies with a mean followup of approximately 8 years in terms of Musculoskeletal Tumor Society Score (MSTS), physical examination, and gait analysis. However, the effects of residual thigh-shank length on gait have not been explored to our knowledge. Questions/purposes We asked: (1) Do differences in the length of the surgically treated residual thigh-shank relative to the contralateral thigh result in altered gait patterns? (2) What were the clinical and functional impairments and radiographic findings of patients who underwent rotationplasty and who survived to adulthood? (3) Do gait analysis findings in adults differ from previously reported findings in children in terms of relevant gait parameters such as maximal ground reaction forces and sagittal knee angles? Methods From January 1986 to December 2009, 254 children (age range, 3-14 years) affected by high-grade bone sarcomas located in the distal half of the femur were surgically treated at our institute. Forty-two of these patients (16.5%) underwent rotationplasty. During this period, three adolescents older than 15 years were treated by rotationplasty owing to the tumor volume and extracompartmental involvement. In total, 45 patients underwent rotationplasty. From January 1986 to December 2000, rotationplasty generally was the preferred treatment for patients younger than 9 years with a high-grade bone sarcoma calling for an intra-or extraarticular resection of the distal femur, as long as the sciatic nerve could be spared. From January 2001, the procedure was not used as often. Of the 45 patients who underwent a rotationplasty, 14 died of disease at a mean of 37 months (31%); 31 patients (69%) were survivors at the time the study was done, 29 of whom were continuously disease free (64%) and two had no evidence of disease after a pulmonary metastasectomy (5%). These 31 patients were invited to participate in the study, and 25 of the 31 agreed to participate. There were 15 males and 10 females with a mean age of 23.8 years (SD, 7.5 years) and mean followup of 15 years (SD, 5.8 years). Clinical assessment included the MSTS score (total score ranges between 0 and 30 with 0 Each author certifies that he or she, or a member of his or her immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research 1 editors and board members are on file with the publication and can be viewed on request. Clinical Orthopaedics and Related Research 1 neither advo...

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Section: Introductionmentioning

confidence: 99%

How Much Clinical and Functional Impairment do Children Treated With Knee Rotationplasty Experience in Adulthood?

Benedetti

Okita

Recubini

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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“…Functionally, rotationplasty has been shown to be superior to an above knee amputation [8] and similar to a patient with megaprosthesis [9]. Long-term follow-up of rotationplasty found no reduction in psychosocial adaptation, and life contentment was about the same as in healthy persons [10].…”

Section: Discussionmentioning

confidence: 98%

Facilitating rotationplasty

Puri

Agarwal

2007

Journal of Surgical Oncology

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Rotationplasty, a unique surgical procedure where the ankle is converted into the knee joint after shortening and 180 degree external rotation of the limb is a well accepted alternative to amputation in musculoskeletal oncology. The required vascular dissection can be quite difficult as the concerned vessels lie in the posterior compartment from the distal third of the thigh downwards. The problem is compounded when rotationplasty is used as a salvage procedure after failed limb-sparing tumor surgery because of the additional fibrosis and stiffness at the level of the prosthetic knee joint. We advocate making the femoral osteotomy at an early stage in the procedure so as to allow free rotation of the distal limb thus making the popliteal fossa and the limb distal to it face anteriorly to facilitate the neuro vascular dissection. We also describe use of a novel cutting jig to ensure a perfect horizontal cut perpendicular to the long axis of the bone while making the femoral and tibial osteotomies. This ensures maximal surface contact between the apposing femoral and tibial cut ends, promoting early bony union.

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“…Today, rotationplasty is one option for surgical management of musculoskeletal tumors, particularly in children [2,3,8,18] or as a salvage option after failed reconstruction [4,5,13]. Overall function reportedly is excellent [4,10,15]. There have been no problems with wound healing.…”

Section: Introductionmentioning

confidence: 99%

A New Incision Technique to Reduce Tibiofemoral Mismatch in Rotationplasty

Ossendorf

Exner

Fuchs

2010

Clinical Orthopaedics &Amp; Related Research

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Rotationplasty provides stable and durable biologic reconstruction after tumor resection around the knee and renders reliable results, in young patients. However, after resection of the tumor, there is often a mismatch between the circumference of the proximal (femoral) and the distal (tibial) parts. Because rotationplasty includes an intercalary amputation where the ends are readapted, there is always a mismatch of the proximal and distal circumferences of the soft tissue envelope. To facilitate skin closure without tension and to avoid impaired wound healing and subsequent infections, the type of incision is critical and must be carefully planned. We present a new incision technique for rotationplasty about the knee. Half of the difference of the incision length of the proximal and distal circumferences represents the base of the triangle proximally, medially and laterally of the thigh. After adapting both ends, the peak of this flat triangle is distally adapted via a vertical incision which allows it to match unequal circumferences. This technique was used in eight patients, in all of whom the wounds healed uneventfully.

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Rotationplasty--quality of life after 10 years in 22 patients

Cited by 66 publications

References 18 publications

How Much Clinical and Functional Impairment do Children Treated With Knee Rotationplasty Experience in Adulthood?

How Much Clinical and Functional Impairment do Children Treated With Knee Rotationplasty Experience in Adulthood?

Facilitating rotationplasty

A New Incision Technique to Reduce Tibiofemoral Mismatch in Rotationplasty

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