Rotationplasty after failure of a knee prosthesis for a malignant tumour of the distal femur.
Failure of massive knee endoprostheses implanted for malignant tumours of the distal femur in children presents a difficult problem. We present the results of rotationplasty undertaken under these circumstances in four boys. They had been treated initially at a mean age of 9.5 years for a stage-IIB malignant tumour of the distal femur by resection and implantation of a massive knee endoprosthesis. After a mean period of eight years and a mean of four operative procedures, there was failure of the endoprosthesis because of aseptic loosening in two and infection in two. Function was poor with a mean Musculoskeletal Tumor Society score of 7.5/30, and considerable associated psychological problems. At a mean follow-up of 4.5 years after rotationplasty there was excellent function with a mean score of 27.5/30 and resolution of the psychological problems.
Wicart
P
P
Henri Descartes University and Saint-Vincent de Paul Hospital, Paris, France.
Mascard
E
E
Missenard
G
G
Dubousset
J
J
D000293:Adolescent; D000328:Adult; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D005266:Femoral Neoplasms / Q000601:surgery*; D006801:Humans; D007720:Knee Prosthesis / Q000009:adverse effects*; D008297:Male; D019637:Orthopedic Procedures / Q000379:methods* / Q000523:psychology; D012516:Osteosarcoma / Q000601:surgery*; D011475:Prosthesis Failure / Q000523:psychology; D020127:Recovery of Function; D012086:Reoperation / Q000379:methods* / Q000523:psychology / Q000534:rehabilitation; D016896:Treatment Outcome