Rotationplasty type BI versus type BIIIa in children under the age of ten years : Should the knee be preserved?

• Published in: Journal of bone and joint surgery. British volume Vol. 87; no. 3; pp. 395 - 400
• Main Authors: HARDES, J, GOSHEGER, G, VACHTSEVANOS, L, HOFFMANN, C, AHRENS, H, WINKELMANN, W
• Format: Journal Article
• Language: English
• Published: London British Editorial Society of Bone and Joint Surgery 01.03.2005; British Editorial Society of Bone & Joint Surgery
• Edition: British volume
• Subjects: Biological and medical sciences; Child; Child, Preschool; Diseases of the osteoarticular system; Female; Femoral Neoplasms - diagnostic imaging; Femoral Neoplasms - surgery; Femur - surgery; Humans; Male; Medical sciences; Orthopedic surgery; Osteosarcoma - diagnostic imaging; Osteosarcoma - surgery; Postoperative Complications - etiology; Radiography; Range of Motion, Articular; Sarcoma, Ewing - diagnostic imaging; Sarcoma, Ewing - surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Treatment Outcome; Human; Knee; Postoperative; Proximal; Femur; Prognosis; Evaluation scale; Rheumatology; Orthopedic surgery; Treatment; Orthopedics; Complication; Tumor; Child; Age; Comparative study
• ISSN: 0301-620X; 2049-4394; 2044-5377; 2049-4408
• DOI: 10.1302/0301-620x.87b3.14793

Type BI rotationplasty is currently indicated for children with tumours of the proximal femur whereas type BIIIa rotationplasty is reserved for those in which the entire femur has to be removed. Our aim was to compare these two types of rotationplasty and determine whether the knee should be preserved in children with tumours of the proximal femur. We compared the post-operative complications, oncological outcome, range of movement, Enneking score and radiographs of six children, who had undergone type BI rotationplasty with those of 12 who had undergone type BIIIa rotationplasty. Patients with type BI rotationplasty had a mean Enneking score of 21.6 compared with 24.4 in those with type BIIIa rotationplasty, and worse mean results in all of the parameters investigated. We conclude that type BI rotationplasty has a worse functional outcome and more complications than type BIIIa rotationplasty in children under the age of ten years.