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Functional performance after tibial rotationplasty.

M P Murray, P A Jacobs, D R Gore

    The Journal of Bone and Joint Surgery. American Volume
    |March 1, 1985
    PubMed
    Summary
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    Tibial rotationplasty allows children with distal femur osteosarcoma to regain significant lower limb function. Rotated calf muscles effectively extend the prosthetic knee, enabling walking, running, and stair climbing.

    Area of Science:

    • Orthopedic surgery
    • Pediatric oncology
    • Biomechanics

    Background:

    • Osteosarcoma of the distal femur often requires limb-sparing surgery or amputation.
    • Tibial rotationplasty is a limb reconstruction technique involving rotation of the tibia.
    • Assessing functional outcomes after rotationplasty is crucial for patient management.

    Observation:

    • Two children underwent tibial rotationplasty for distal femur osteosarcoma.
    • Muscle strength, joint motion, gait, and electromyography (EMG) of the ankle and knee were evaluated during various activities.
    • Plantar flexor strength was reduced on the prosthetic side.

    Findings:

    • EMG data indicated that the rotated calf muscles significantly contributed to prosthetic knee extension.
    • Despite strength deficits, children exhibited comparable walking speeds to normal peers.

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  • Children could run, ascend stairs using both limbs, and engage in recreational activities.

    • Implications:

    • Tibial rotationplasty demonstrates potential as a viable alternative to above-knee amputation for similar pediatric cases.
    • This surgical approach can restore substantial functional mobility and quality of life.
    • Further research into optimizing functional outcomes after rotationplasty is warranted.