Every year, children between ages 0 to 14 have a 2% chance of getting osteosarcoma, a type of bone cancer. This highly aggressive disease typically requires surgery as the primary method to eliminate the tumor and prevent its recurrence. In cases where bone cancer affects the knee area, rotationplasty is the surgical procedure of choice.
What is Rotationplasty?
Rotationplasty is a functional surgical procedure; the goal is to correct deformities on a patient’s body. A deformity is there in the first place because, in osteosarcoma involving the knee, the knee and a part of the area around it must be removed to discard the tumour. As a result, the patient’s leg only has a foot, and the upper part of the quad is left. In order for a prosthetic to be used, a joint is needed to connect the prosthetic with the body. Without a knee, the solution is to use the ankle as the replacement knee! Rotationplasty is the surgical procedure that turns an ankle into a knee.
How Does Rotationplasty Work?
Firstly, certain conditions must be met before the procedure: an intact sciatic nerve that allows your legs to be connected to the central nervous system and preoperative planning of exact remaining bone growth so that when the child grows up, their legs will be even and not affect their walking.
Now we will really get into the procedure.
First, the lower part of the femur, the knee, and the upper part of the tibia are removed while the sciatic nerves are retained.
Second, the lower part of the legs with the ankles is rotated 180 degrees so that the foot is facing backwards. This occurs so the ankle can act like a knee.
Third, the lower part of the legs is attached to the upper part of the legs.
Fourth, the child goes through rehabilitation and gets a prosthetic in order to regain mobility.
Rotationplasty is a wonderful case of anatomical thinking. In procedures where huge limbs must be cut off and thrown away to save the patient, it is oftentimes good to think, what else can one do with the body part to maximize its function? The results might look weird, but for these cancer survivors, it is a method to achieve a better quality of life and independence in mobility. In all, surgery requires a lot of creative and flexible thinking, and in high-risk procedures where anything can happen, it is a great skill to have.
Works Cited:
“Rotationplasty.” Physiopedia, https://www.physio-pedia.com/Rotationplasty.
Leonard, Jayne. “What to know about bone cancer.” Medical News Today, MediLexicon International, 2 Nov. 2016, https://www.medicalnewstoday.com/articles/314009#1.
Wells, Diana. “Bone Cancer in Knee: Symptoms, Diagnosis, and Treatment.” Medical News Today, MediLexicon International, https://www.medicalnewstoday.com/articles/bone-cancer-in-knee#treatment.
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