What We Treat

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.

Services We Offer

For families that opt to have a rotationplasty, we have the expertise and experience needed for a successful procedure. Our team of pediatric orthopaedic surgeons, hematology and oncology doctors, physical therapists and prosthetists work together to make sure each child recovers completely with as much function as possible.

Our team can introduce patients and families to peers who have been through the procedure and recovery. This allows both children and parents to ask any questions they might have about rotationplasty to those who have first-hand experience.

After the surgery, our physical therapists can help develop the child’s range of motion and strength to best prepare him for using a prosthesis.
Your child’s pediatric orthopaedic surgeon and physical therapist will follow him very closely after surgery. When your child is ready, our Orthotics and Prosthetics Program can fit him with a prosthesis that will help him build function and independence. As he grows, we can help his prosthesis grow with him, making regular adjustments and fittings as needed.

If your child is an athlete or wishes to participate in sports, our Adaptive Sports Program can introduce him to a sport that he will be able to play with his new leg. Members of the program can also connect him with other adaptive athletes and the resources he needs to get in the game.


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