Rotationplasty in skeletally immature patients. Long-term followup results

Area of Science:

• Orthopedic Surgery
• Pediatric Oncology
• Skeletal Reconstruction

Background:

• Osteosarcoma is a primary bone cancer often affecting children and adolescents.
• Surgical management of knee osteosarcoma in skeletally immature patients presents challenges for limb preservation.
• Van Nes rotationplasty is a limb-sparing technique that allows for functional reconstruction after tumor resection.

Purpose of the Study:

• To evaluate the long-term functional outcomes and durability of a modified Van Nes rotationplasty in skeletally immature patients with Grade IIB osteosarcoma of the knee.

Main Methods:

• A cohort of 21 skeletally immature patients with Grade IIB osteosarcoma underwent modified Van Nes rotationplasty.
• Fourteen patients were available for long-term follow-up, averaging 8 years (range: 4 to 10.5 years).
• Functional outcomes were assessed using Enneking's scoring system.

Main Results:

• All 14 followed patients achieved good or excellent functional results.
• No patient reported limitations in recreational, sporting, or career pursuits due to the reconstruction.
• The modified Van Nes rotationplasty demonstrated durability with no increase in late complications.

Conclusions:

• Modified Van Nes rotationplasty is a successful and durable limb-sparing procedure for pediatric knee osteosarcoma.
• This technique provides excellent functional restoration, enabling patients to achieve their life goals.
• It represents a viable option for managing challenging cases of osteosarcoma in growing children.