ROTATIONPLASTY AS AN EFFECTIVE LIMB SALVAGE OPTION IN THE ADULT POPULATION

Rotationplasty is a limb salvage option for musculoskeletal tumors of the lower extremity and was historically indicated for the pediatric population. Indications, however, have expanded considering the success of this procedure. The aim of this study is to evaluate functional outcomes and complications in adults undergoing rotationplasty for oncologic and non-oncologic indications. Six (2 male:4 female) adult patients undergoing rotationplasty at our institution were reviewed. Mean age was 33±17 (range 22–65) years and mean follow up was 1±0.4 years. Indications for rotationplasty included primary malignancy (n=2) and previous limb salvage attempts (n=4). One patient undergoing rotationplasty for malignancy experienced recurrence requiring hip disarticulation at 5 months. The remaining patients had a minimum one year follow up and were included in functional outcomes. Prosthetic fitting occurred at mean 4±2 months post-operatively in the 5 patients with rotationplasty at final follow up. All patients were ambulating without gait aids, and 4/5 returned to work. Four patients were functioning at a K-level 3 with their prosthesis, while one patient was functioning at a K-level 4. On examination, mean extension lag was 19±14°. Mean MSTS score was 76±30%. Post-operative complications included expanding hematoma (n=1) requiring return to the operating room and delayed wound healing (n=1). At most recent follow up, 3/5 patients reported ongoing pain, including neuropathic pain, Achilles tendonitis, and residual limb sensitivity. Rotationplasty is an effective option for limb salvage in the adult population with promising functional outcomes and should be considered in adult patients requiring resection of the knee joint.