Rotationplasty as a reconstructive operation after tumor resection.
Reconstruction in the skeletally immature patient following resection of osteosarcoma about the knee is a challenging problem. Salvaging of the limb with allogeneic or prosthetic replacement results in a shortened limb with functional limitations. Arthrodesis yields a stiff and shortened limb. The so-called growing prosthesis has a high complication rate and is still unproven. However, rotationplasty has been successfully used as a reconstructive technique following resection of these types of tumors in the skeletally immature patient. A limb with normal sensation and proprioceptions, adequate range of motion, and without leg-length discrepancies, functional limitations, or painful neuroma is to be expected. Although a prosthesis must be worn, these patients are active and participate in unrestricted physical activity. Cosmetic acceptance has not been a problem and complications are minimal. Thus, rotationplasty requires only a single operation and results in a highly functional limb.
Merkel
K D
KD
Orthopaedic Oncology Unit, Massachusetts General Hospital, Boston 02114.
Gebhardt
M
M
Springfield
D S
DS
D000293:Adolescent; D000328:Adult; D000843:Ankle Joint; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005266:Femoral Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007720:Knee Prosthesis / Q000592:standards*; D009367:Neoplasm Staging; D012516:Osteosarcoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D011859:Radiography; D016059:Range of Motion, Articular; D016042:Transplantation, Heterotopic