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Rotationplasty after failed limb salvage: an alternative to amputation
Ashish Gulia1, Ashwin Prajapati2, Srinath Gupta2
1Bone and Soft Tissue Services, Department of Surgical Oncology, Tata Memorial Hospital and Homi Bhabha National Institute (HBNI), Mumbai, India. aashishgulia@gmail.com.
Summary
Rotationplasty is a successful salvage procedure for patients with multiple failed limb salvage surgeries, offering good functional outcomes and low complication rates in carefully selected cases.
Area of Science:
- Orthopedic Surgery
- Musculoskeletal Oncology
Background:
- Limb salvage surgery for musculoskeletal tumors can lead to complications.
- Reconstruction failures may necessitate further interventions, sometimes leading to amputation.
Purpose of the Study:
- To evaluate the outcomes of rotationplasty as a salvage procedure.
- To assess the success rate and functional results after multiple failed limb salvage surgeries.
Main Methods:
- Retrospective review of 14 patients undergoing rotationplasty after failed limb salvage (1999-2018).
- Indications included infection, failed megaprosthesis, unstable reconstruction, and recurrence.
- Mean prior surgeries: 5 (range 2-7).
Main Results:
- One patient required early amputation due to vascular complications.
- 13 patients had no surgical complications post-rotationplasty.
- Mean Musculoskeletal Tumor Society score was 26 (range 23-30) in evaluable patients.
Conclusions:
- Rotationplasty is a viable salvage option after multiple lower limb salvage failures.
- This procedure demonstrates good success rates and functional outcomes.
- Careful patient selection is crucial for optimal results.
