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Surgical Treatment of Malignant and Aggressive Bone Tumors Around the Knee by Segmental Resection and Rotationplasty

 Soo Bong Hahn  ;  Hong Jun Park  ;  Kyoo Ho Shin  ;  Sung Hun Kim  ;  Hyoung Sik Kim 
 YONSEI MEDICAL JOURNAL, Vol.44(3) : 485-492, 2003 
Journal Title
Issue Date
Adolescent ; Adult ; Bone Neoplasms/surgery* ; Child ; Child, Preschool ; Female ; Giant Cell Tumors/surgery* ; Humans ; Knee Joint/surgery* ; Male ; Neoplasm Recurrence, Local ; Orthopedic Procedures*/adverse effects ; Osteosarcoma/surgery* ; Retrospective Studies ; Rotation ; Sarcoma, Synovial/surgery* ; Treatment Outcome
Knee ; bone tumor ; segmental resection ; rotationplasty
In patients having malignant or aggressive bone tumors around the knee joint and requiring amputation, segmental resection and rotationplasty was performed and the clinical results were analyzed.

Twenty-six patients underwent segmental resection and rotationplasty between February 1988 and June 1994. The mean follow-up period was 57 (6 - 120) months and the average age of patients was 21.4 (5 - 37) years. Out of 26 patients, there were 18 osteosarcomas (≥ or = stage IIB), 2 synovial sarcomas, and 6 giant cell tumors.

Clinical results were evaluated by the Shriner's rating system. Four patients were excluded due to death or amputation and the remaining twenty-two patients were included for assessment. Eighteen patients had excellent results, 3 good, and 1 fair. Range of motion of the ankle joint was -11 (dorsiflexion) - 80 (plantarflexion) degrees and daily walking activity was possible. Local recurrence developed in 2 patients and distant metastasis in 10. Early complications include 3 thromboses and 1 sepsis, and late complications were 6 nonunion, 2 malrotation and 1 stiffness of the ankle joint.

Rotationplasty, which is functionally excellent, may serve as an effective partial limb salvage procedure, especially in patients younger than 10 years old who are expected to have leg length discrepancy or loosening of the tumor prosthesis due to the growth of the medullary cavity or when amputation is inevitable for a wide resection margin.
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1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Sung Hun(김성훈)
Kim, Hyoung Sik(김형식) ORCID logo https://orcid.org/0000-0002-9303-4116
Shin, Kyoo Ho(신규호)
Hahn, Soo Bong(한수봉)
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