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Prosthetic Fitting After Rotationplasty of the Knee

So, Noel F. MD; Andrews, Karen L. MD; Anderson, Kimberly PT; Gozola, Michael A. CP; Shives, Thomas C. MD; Rose, Peter S. MD; Shaughnessy, William J. MD; Sim, Franklin H. MD

American Journal of Physical Medicine & Rehabilitation: April 2014 - Volume 93 - Issue 4 - p 328–334
doi: 10.1097/PHM.0000000000000044
Original Research Articles

Objective The objectives of this study were to describe the authors’ experience with the timeline for prosthetic fitting after rotationplasty of the knee and to determine factors that may be associated with earlier prosthetic fitting.

Design The authors conducted a retrospective observational study of 12 patients who underwent rotationplasty of the knee and received prosthetic care at this institution. All patients had oncologic causes for surgery.

Results The median age at amputation was 10 yrs. The overall survival rate was 92%. Five patients received a preliminary bypass prosthesis. All 12 patients were successfully fitted with a definitive prosthesis. Three patients were fitted within 90 days; two of these three patients did not require chemotherapy. The median time for definitive prosthetic fitting in the ten patients requiring chemotherapy was 230.5 days (range, 85–425 days). Nine patients had documentation supporting a return to sport/premorbid physical recreational activities.

Conclusions In the authors’ experience, chemotherapy was associated with delayed definitive prosthetic fitting. Typically, the patients who required rotationplasty for cancer completed fitting with a definitive prosthesis in 6 mos. The findings of this study validate previous reports and confirm that most rotationplasty patients have excellent outcomes with return to premorbid physical activities.

From the Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota (NFS, KLA, KA); Prosthetic Laboratories of Rochester, Minnesota (MAG); and Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota (TCS, PSR, WJS, FHS).

All correspondence and requests for reprints should be addressed to Karen L. Andrews, MD, Department of Physical Medicine and Rehabilitation, Mayo Clinic, 200 First St SW, Rochester, MN 55905.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

© 2014 by Lippincott Williams & Wilkins