Rotationplasty is a limb-sparing surgical option for children who have osteosarcoma, or bone cancer, in the femur (thigh bone), knee or tibia (shin bone). It is also an option for children with congenital disorders like proximal femoral focal deficiency (PFFD) and can be an alternative to amputation.
In a rotationplasty procedure for cancer, the cancerous part of the leg is removed. This usually includes the knee. The healthy, lower part of the leg is then rotated 180 degrees so the foot is turned around. It is then attached to the remaining part of the upper part of the leg. This allows the healthy ankle joint to work as a knee joint. The new knee joint offers enough function to power below-the-knee prosthesis.
To treat PFFD with a rotationplasty, the lower section of the shortened leg, including the foot, is turned 180 degrees. It is then reconnected with the upper section. Children with this condition may require additional surgeries to correct the alignment or position of the hip and femur.
Benefits of a Rotationplasty
The idea of turning his foot around 180 degrees might seem strange at first to you or your child. But there are several benefits to a rotationplasty over amputation and other limb-sparing surgeries.
The biggest benefit is improved function and durability. The new knee joint allows children to have a more natural gait and stride with a below-the-knee prosthesis. It also makes it likely he will be able to participate in the same sports and activities as before the cancer, including:
- Crossing his legs
- Kicking a ball
- Walking up and down stairs
This new knee joint provides feeling and sensation, allowing your child to know where his knee is in space.
A rotationplasty procedure often has fewer complications and results in a more durable joint. This means there are typically fewer secondary procedures. As your child grows, his new knee joint will become level with his other knee, eliminating any limb-length differences.