title: Long-term functional outcome and quality of life following rotationplasty for treatment of malignant tumors.
abstract: BACKGROUND
  Malignant bone tumors of the lower extremity are more frequently found in children and adolescents than in adults. Modern treatment regimens led to high limb salvage rates and offer the choice between endoprosthetic replacement and rotationplasty in many cases. Rotationplasty has proven to be an effective, highly functional option in short- and mid-term studies. Aim of this study was to assess long-term results regarding quality of life and functionality after rotationplasty and to compare the obtained results to a representative healthy German sample cohort.
  
  
  METHODS
  In total 12 patients who underwent rotationplasty between 1991 and 2001 were enrolled in this study. After physical examination, they were evaluated regarding health related quality of life, functional outcome and psychosocial status. While quality of life was mainly assessed using the SF-36 (The Short Form (36) Health Survey v2), functional outcome was measured using the musculoskeletal tumor society score (MSTS) as well as the Tegner activity level scale.
  
  
  RESULTS
  Average age at the time of surgery was 19 ± 10 year. and 32 ± 11 year. at the time of follow up. Mean follow-up was 14 ± 9 years. The SF-36 scores accounted for 80.4 ± 15.7 regarding physical functioning, for 78.1 ± 24.1 regarding the physical role functioning, for 74.1 ± 17.6 regarding bodily pain and for 71.8 ± 26.1 regarding general health. SF-36 score for vitality was 75.0 ± 12.8, for social functioning 98.9 ± 3.6, 88.2 ± 23.9 for emotional role functioning and 89.6 ± 10.1 for the mental health. Comparison to a representative German sample cohort revealed significantly higher patient's scores for vitality, social functioning and mental health (p < 0.05). The overall MSTS resulted in an average of 64 ± 12 % and the Tegner activity level scale accounted for 4.1 ± 0.6 pts.
  
  
  CONCLUSIONS
  The presented long-term results indicate that rotationplasty provides a high quality of life. Patients are satisfied with a good functional outcome regarding activities of daily life and even sports.
authors.affiliation: Department of Orthopedics and Sports Orthopedics, Klinikum rechts der Isar, Technische Universitaet Muenchen, Ismaningerstrasse 22, 81675, Munich, Germany. ggradl@mac.com.
authors.forename: Guntmar
authors.initials: G
authors.lastname: Gradl
authors.affiliation: Department of Orthopedics and Sports Orthopedics, Klinikum rechts der Isar, Technische Universitaet Muenchen, Ismaningerstrasse 22, 81675, Munich, Germany. lukas.postl@tum.de.|Department of Trauma Surgery, Klinikum rechts der Isar, Technische Universitaet Muenchen, Munich, Germany. lukas.postl@tum.de.
authors.forename: Lukas K
authors.initials: LK
authors.lastname: Postl
authors.affiliation: Department of Orthopedics and Sports Orthopedics, Klinikum rechts der Isar, Technische Universitaet Muenchen, Ismaningerstrasse 22, 81675, Munich, Germany. uli_lenze@web.de.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Lenze
authors.affiliation: Department of Orthopedics and Sports Orthopedics, Klinikum rechts der Isar, Technische Universitaet Muenchen, Ismaningerstrasse 22, 81675, Munich, Germany. josef.stolbergstolberg@googlemail.com.
authors.forename: Josef
authors.initials: J
authors.lastname: Stolberg-Stolberg
authors.affiliation: Department of Orthopedics and Sports Orthopedics, Klinikum rechts der Isar, Technische Universitaet Muenchen, Ismaningerstrasse 22, 81675, Munich, Germany. pohlig@ortho.med.tum.de.
authors.forename: Florian
authors.initials: F
authors.lastname: Pohlig
authors.affiliation: Department of Orthopedics and Sports Orthopedics, Klinikum rechts der Isar, Technische Universitaet Muenchen, Ismaningerstrasse 22, 81675, Munich, Germany. rechl@ortho.med.tum.de.
authors.forename: Hans
authors.initials: H
authors.lastname: Rechl
authors.affiliation: Department of Orthopedics, Klinikum der Universitaet Muenchen, Ludwig-Maximilians-Universitaet, Munich, Germany. m.schmitt-sody@medicalpark.de.
authors.forename: Markus
authors.initials: M
authors.lastname: Schmitt-Sody
authors.affiliation: Department of Orthopedics and Sports Orthopedics, Klinikum rechts der Isar, Technische Universitaet Muenchen, Ismaningerstrasse 22, 81675, Munich, Germany. Eisenhart@tum.de.
authors.forename: Ruediger
authors.initials: R
authors.lastname: von Eisenhart-Rothe
authors.affiliation: Department of Orthopedics and Sports Orthopedics, Klinikum rechts der Isar, Technische Universitaet Muenchen, Ismaningerstrasse 22, 81675, Munich, Germany. dr.kirchhoff@mac.com.|Department of Trauma Surgery, Klinikum rechts der Isar, Technische Universitaet Muenchen, Munich, Germany. dr.kirchhoff@mac.com.
authors.forename: Chlodwig
authors.initials: C
authors.lastname: Kirchhoff
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D001696:Biomechanical Phenomena; D001859:Bone Neoplasms / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D002648:Child; D004644:Emotions; D005260:Female; D005858:Germany; D006801:Humans; D023821:Limb Salvage; D035002:Lower Extremity / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008603:Mental Health; D019637:Orthopedic Procedures / Q000009:adverse effects / Q000379:methods*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology; D017060:Patient Satisfaction; D011788:Quality of Life; D020127:Recovery of Function; D012189:Retrospective Studies; D012919:Social Behavior; D012983:Soft Tissue Neoplasms / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult