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KMID : 0613320010070020051
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Journal of the Korean Bone and Joint Tumor Soceity
2001 Volume.7 No. 2 p.51 ~ p.58
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Segmental Resection and Rotationplasty of Malignant and Aggressive Bone Tumors Around Knee
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Hahn Soo-Bong
Park Hong-Jun
Kim Hyoung-Sik
Kim Seong-Hun
Shin Kyoo-Ho
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Abstract
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Purpose: In patients having malignant and aggressive bone tumors around knee joint requir-ing amputation, segmental resection and rotationplasty were performed and the clinical results were analyzed.
Materials and Methods: Twenty-six patients underwent segmental resection and rotation-plasty between February 1988 and June 1994, because limb salvage with tumor prosthesis after removal of tumor was impossible. The mean follow-up of malignant tumors was 57(6~120) months and the average age of patients was 21.4(5~37) years old. Out of 26 patients, there were 18 osteosarcoma(≥stage IIB), 2 synovial sarcoma, and 6 giant cell tumor.
Results: Clinical results were evaluated by the Shriner ’s rating system. Four patients were excluded due to death or amputation and remaining 22 patients were included for assessment. Eighteen patients had excellent result, 3 good, and 1 fair. Range of motion of ankle joint was -11 (dorsiflexion)~80(plantarflexion) degrees and daily walking activity with prosthesis was possi-ble. Local recurrence developed in 2 patients and distant metastasis in 10. Early complications had 3 thrombosis and 1 sepsis, and late complications had 6 nonunion, 2 malrotation and 1 stiff-ness of ankle joint.
Conclusion: Rotationplasty which is functionally excellent may serve as an effective partial limb salvage procedure, especially in patients less than 10 years old that lower extremity dis-crepancy or loosening tumor prosthesis due to enlargement of medullary cavity are anticipated or amputation is inevitable for wide resection margin.
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KEYWORD
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Knee, Bone tumor, Segmental resection, Rotationplasty
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