Rotationplasty for bone tumors: is there still a role?

We evaluated the disease status and functional results in 30 patients (range, 6-25 years) who underwent rotationplasty for bone sarcomas from January 2000 to February 2004. Plating was used for fixation in all 27 distal femur resections. In the proximal femur tumor, the distal femur was contoured and fixed to the ilium with cancellous screws. In the two cases involving the entire femur, the upper end of the tibia was articulated with the acetabulum in one case and an Austin Moore prosthesis was inserted in the upper end of the tibia in the other. Two patients underwent an amputation after postoperative vascular compromise. Other complications included venous congestion in two patients, who recovered after exploration, partially recovered nerve palsy in one, wound infection in two, local recurrence in one, and nonunion with subsequent bone grafting in one. Functional evaluation was documented in 26 patients with a followup ranging from 24 to 60 months. Using the Musculoskeletal Tumor Society scoring system, the score was 25 or greater in 20 of 26 patients. In appropriately indicated cases, rotationplasty provides good local disease control and good function.