Treatment of osteosarcomata of the distal femur by rotation-plasty

Abstract

Rotation-plasty was carried out on fifteen patients--10 male and 5 female patients aged between 6 and 32--with an osteosarcoma of the distal femur following resection of the tumor. In the operation the lower leg was rotated through 180 degrees after resection of the distal femur and knee joint so that the ankle joint was effectively turned into a "knee joint". The indication for this operation was initially limited to children for whom the only possible therapeutic alternative was a high above-knee amputation. The surprisingly good functional rehabilitation justifies the indication of this method as an alternative to an endoprosthesis or arthrodesis even for young adults. In spite of the cosmetically very unusual position of the foot, none of the patients has so far experienced psychological problems thanks to suitable guidance. Both from an oncological and psychological point of view, this method represents an extremely responsible operation and should therefore only be carried out by hospital departments specializing in the therapy of bone tumors.

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

“…The rotationplasty described by Borggreve 1930 and Van Nes 1950 was used by Salzer et al (1981) as an alternative procedure for distal femoral tumors. Winkelmann (1983Winkelmann ( , 1986Winkelmann ( , 2000 widened the indication to tumors in the proximal femur.…”

Multimodale interdisziplinäre Therapie als Voraussetzung für Verbesserungen von Funktion und Langzeitüberleben bei Patienten mit einem hochmalignen Osteosarkom der Extremitäten

“…Bei einer Patientin mit ausgedehntem Osteosarkom des distalen Femurs (509 ml) und langstreckigem Kontakt zu den Femoral-bzw. Poplitealgefäßen wurde eine Borggreve-Plastik mit Resektion und Reanastomosierung der Gefäße durchgeführt [43]. Nach Resektion des extraskelettalen Osteosarkoms war lediglich eine Weichteilrekonstruktion erforderlich.…”

Rotationplasty (Borggreve/Van Nes and modifications) as an alternative to amputation in failed reconstructions after resection of tumours around the knee joint

“…Later it was adapted to preserve function after extensive resections of tumours of the femur by Salzer et al [3]. Today it is mainly used as a primary treatment in young children with sarcoma when amputation is needed to achieve adequate margins, or when endoprosthetic replacement would result in significant shortening as a result of loss of growth [4].…”