The Journal of Bone and Joint Surgery, Vol 73, Issue 9 1365-1375, Copyright © 1991 by Journal of Bone and Joint Surgery, Inc
Rotationplasty for limb salvage in the treatment of malignant tumors at the knee. A follow-up study of seventy patients
F Gottsauner-Wolf, R Kotz, K Knahr, H Kristen, P Ritschl and M Salzer
Orthopaedic University Clinic, Vienna, Austria.
Seventy patients who had a rotationplasty for treatment of a malignant
tumor in the region of the knee (the femur or the tibia) between 1974 and
1987 were followed for two to thirteen years (mean duration of follow-up,
four years). Forty-seven patients had a stage-IIB osteosarcoma; the
remaining twenty-three patients had a malignant fibrous histiocytoma, a
chondrosarcoma, a Ewing sarcoma, or a giant-cell tumor. The most severe
postoperative complication was occlusion of the reanastomosed vessels
(seven patients), leading to amputation proximal to the knee in three
patients. Other complications were problems with wound-healing (eight
patients), transient nerve palsy (five patients), irreversible nerve palsy
(two patients), pseudarthrosis (four patients), and rotational malalignment
(one patient). Late complications included eight fractures, two infections,
two delayed unions, and one lymphatic fistula. More than half of the
patients were free of complications related to the operative procedure.
Forty-four of the patients who had a stage-IIB osteosarcoma could be
followed, and their data were analyzed for survival statistics. These
patients had a 58 percent rate of disease-free survival and a 70 per cent
rate of over-all survival. One patient had a local recurrence five years
after the operation.