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Rotationplasty after failed limb salvage: an alternative to amputation

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

Limb salvage procedures for musculoskeletal tumors have inherent complications. Though most complications can be managed with retention of the reconstructions, occasionally salvaging these reconstructions is not possible. We evaluated the outcomes of patients undergoing rotationplasty after multiple failed revisions of limb salvage surgery and document the success rate of this “salvage” technique and the subsequent functional outcome of these patients.

Method

Between January 1, 1999, and December 31, 2018, 14 patients (12 male and 2 female) with a median age of 24 years (11–51 years) underwent rotationplasty after multiple failed revisions of limb salvage surgery. Indication for rotationplasty was infection (10 patients), failed megaprosthesis (2 patients), unstable biological reconstruction (1 patient) and local recurrence (1 patient). The mean number of surgeries done before the patient underwent rotationplasty was 5 (range 2–7).

Results

One patient developed a vascular complication (venous congestion) immediately after rotationplasty and underwent an early amputation. The remaining 13 patients had no surgical complications. Mean Musculo Skeletal Tumor Society score in 13 evaluable patients was 26 (23–30).

Conclusion

Our study demonstrates the utility of rotationplasty as a “salvage” procedure after multiple failed lower limb salvage surgeries. It offers good success rates, low rates of complications and good functional outcomes in carefully selected cases.

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Funding

The authors received no external funding.

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Authors and Affiliations

  1. Bone and Soft Tissue Services, Department of Surgical Oncology, Tata Memorial Hospital and Homi Bhabha National Institute (HBNI), Mumbai, India

    Ashish Gulia, Ashwin Prajapati, Srinath Gupta & Ajay Puri

  2. FMH Orthopädische Chirurgie Und Traumatologie, Orthopaedie Zentrum Zuerich Ozz, 8038, Zurich, Germany

    Ulrich Exner

Authors
  1. Ashish Gulia
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  2. Ashwin Prajapati
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  3. Srinath Gupta
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  4. Ulrich Exner
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  5. Ajay Puri
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Correspondence to Ashish Gulia.

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Gulia, A., Prajapati, A., Gupta, S. et al. Rotationplasty after failed limb salvage: an alternative to amputation. Eur J Orthop Surg Traumatol 33, 1683–1689 (2023). https://doi.org/10.1007/s00590-022-03333-9

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  • DOI: https://doi.org/10.1007/s00590-022-03333-9

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