Functional analysis of patients who have had a modified Van Nes rotationplasty.

Steenhoff, J. R. M.; Daanen, H.A.M.; Taminiau, A. H. M.

doi:10.2106/00004623-199310000-00005

Cited by 44 publications

(15 citation statements)

References 16 publications

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“…Compared with transfemoral amputation, rotationplasty offers better clinical results by preserving the ankle as a new knee with flexionextension capability [19,20,23]. Several studies have documented good functional outcomes after rotationplasty, in patients with with followup as long as a mean of 8 years after surgery, and who were evaluated clinically by means of the Musculoskeletal Tumor Society (MSTS) score and other measures [1, 10-18, 22, 24], and instrumentally by means of gait analysis [5,8,15,22,26]. After rotationplasty, patients were observed to have fewer restrictions for daily activities and sport exercises, even at a competitive level [17,24], and for hobbies compared with patients with endoprostheses [14].…”

Section: Introductionmentioning

confidence: 99%

How Much Clinical and Functional Impairment do Children Treated With Knee Rotationplasty Experience in Adulthood?

Benedetti

Okita

Recubini

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Rotationplasty may be indicated for some children with osteosarcoma in the distal femur or proximal tibia; in properly selected patients, it may offer functional advantages over transfemoral amputation and more durable results than a prosthesis. The clinical and functional outcomes reported for this procedure generally have been limited to studies with a mean followup of approximately 8 years in terms of Musculoskeletal Tumor Society Score (MSTS), physical examination, and gait analysis. However, the effects of residual thigh-shank length on gait have not been explored to our knowledge. Questions/purposes We asked: (1) Do differences in the length of the surgically treated residual thigh-shank relative to the contralateral thigh result in altered gait patterns? (2) What were the clinical and functional impairments and radiographic findings of patients who underwent rotationplasty and who survived to adulthood? (3) Do gait analysis findings in adults differ from previously reported findings in children in terms of relevant gait parameters such as maximal ground reaction forces and sagittal knee angles? Methods From January 1986 to December 2009, 254 children (age range, 3-14 years) affected by high-grade bone sarcomas located in the distal half of the femur were surgically treated at our institute. Forty-two of these patients (16.5%) underwent rotationplasty. During this period, three adolescents older than 15 years were treated by rotationplasty owing to the tumor volume and extracompartmental involvement. In total, 45 patients underwent rotationplasty. From January 1986 to December 2000, rotationplasty generally was the preferred treatment for patients younger than 9 years with a high-grade bone sarcoma calling for an intra-or extraarticular resection of the distal femur, as long as the sciatic nerve could be spared. From January 2001, the procedure was not used as often. Of the 45 patients who underwent a rotationplasty, 14 died of disease at a mean of 37 months (31%); 31 patients (69%) were survivors at the time the study was done, 29 of whom were continuously disease free (64%) and two had no evidence of disease after a pulmonary metastasectomy (5%). These 31 patients were invited to participate in the study, and 25 of the 31 agreed to participate. There were 15 males and 10 females with a mean age of 23.8 years (SD, 7.5 years) and mean followup of 15 years (SD, 5.8 years). Clinical assessment included the MSTS score (total score ranges between 0 and 30 with 0 Each author certifies that he or she, or a member of his or her immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research 1 editors and board members are on file with the publication and can be viewed on request. Clinical Orthopaedics and Related Research 1 neither advo...

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Section: Introductionmentioning

confidence: 99%

How Much Clinical and Functional Impairment do Children Treated With Knee Rotationplasty Experience in Adulthood?

Benedetti

Okita

Recubini

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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“…Nevertheless, the cause–effect relationship might be circular. A previous study (Steenhoff et al , 1993) found that the strength of the plantar flexors and extensors of the ankle in isometric conditions averaged about 70% of those of the unaffected side, thus leaving a potential, despite hypotrophy, for a remarkable muscle power at the ‘new’ knee (Hillmann et al , 2000). Moreover, the ‘extensor’ (i.e.…”

Section: Discussionmentioning

confidence: 99%

Knee rotationplasty: motion of the body centre of mass during walking

Rota

Benedetti

Okita

et al. 2016

International Journal of Rehabilitation Research

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Knee rotationplasty (KRP) is a type of surgery in which the rotated ankle serves as a new knee after being removed for bone tumor. Although this limb salvage surgery is rarely indicated in properly selected patients, it may offer functional advantages over transfemoral amputation, and more durable results compared with a prosthesis. The walking mechanics of adult patients after KRP is believed to be close to that of below-knee amputees. In this study, we evaluated steady-state walking of KRP patients from the viewpoint of the overall muscle power needed to keep the body centre of mass in motion. Three adult patients after KRP, all athletes, were evaluated. Ground reactions during walking were recorded during six subsequent strides on a force treadmill. The positive mechanical work and power sustaining the motion of the centre of mass and the recovery of muscle energy due to the pendulum-like mechanism of walking were computed and compared with those obtained in previous studies from above-knee, below-knee amputees and healthy individuals. In KRP patients, walking was sustained by a muscle power output which was 1.4–3.6 times lower during the step performed on the rotated limb than on the subsequent step. The recovery of muscle energy was slightly lower (0.9) or higher (1.3–1.4 times) on the affected side. In two out of the three KRP patients, our findings were more similar to those from above-knee amputees than to those from below-knee amputees. After KRP, the rotated limb does not necessarily provide the same power provided by below-knee amputation. This may have a relevance for the paralympic classification of KRP athletes.

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“…Quantitative analysis of a non-affected cartilage plate in the hind foot can be potentially used to estimate the original cartilage volume/thickness in the knee (before the onset of the disease), and to more reliably estimate individual cartilage tissue loss in knee OA, since OA in the ankle is rare in comparison with the knee [28]. Moreover, the technique presented may prove useful in monitoring patients with ankle to knee (van Nes) rotationplasty after removal of an osteosarcoma of the distal femur [16,13,41]. It is of great interest, both in the management of these patients as well as from a basic research point of view, to investigate potential changes of articular cartilage in the joints of the hind foot, when these are subjected to loads normally applied to the knee.…”

Section: Discussionmentioning

confidence: 99%

Quantitative cartilage imaging of the human hind foot: Precision and inter‐subject variability

Al-Ali

Graichen

Faber

et al. 2002

Journal Orthopaedic Research

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Alterations of ankle cartilage are observed in degenerative and inflammatory joint disease, but cartilage cannot be directly visualized by radiography. The purpose of this study was therefore to analyze the feasibility and precision of quantitative cartilage imaging in the human hind foot (talocrural, talotarsal, and intertarsal joints), and to report the inter-subject variability for cartilage volume, thickness and surface areas. The feet of 16 healthy volunteers were imaged using a 3D gradient-echo magnetic resonance imaging sequence with water-excitation. After interpolation to a resolution of 1 z 0.125 y 0.125 mm? the cartilage plates were segmented, and the cartilage volume, thickness, and surface areas determined. The precision (four repeated measurements) was examined in eight volunteers, the RMS average CV% being 2.1% to 10.9% in single joint surfaces, and < 3% for the cumulative values of all joints. The mean cartilage thickness ranged from 0.57 i 0.08 (navicular surface) to 0.89 5 0 . 1 9 mm (trochlear surface for tibia). In conclusion this study shows that it is feasibIe to quantify thin cartilage layers in the hind foot under in vivo imaging conditions, and that the precision errors are substantially smaller than the inter-subject variability in healthy subjects.

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Functional analysis of patients who have had a modified Van Nes rotationplasty.

Cited by 44 publications

References 16 publications

How Much Clinical and Functional Impairment do Children Treated With Knee Rotationplasty Experience in Adulthood?

How Much Clinical and Functional Impairment do Children Treated With Knee Rotationplasty Experience in Adulthood?

Knee rotationplasty: motion of the body centre of mass during walking

Quantitative cartilage imaging of the human hind foot: Precision and inter‐subject variability

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