Original Article

Evaluation of the long-term functional outcome and quality of life after rotationplasty in the management of primary malignant bone tumors about the knee in Children

¹ Orthopaedic Surgery Department, Leuven University Hospital, Leuven 3000, Belgium
² Institute for Orthopaedic Research and Training, Department of Development and Regeneration, KU Leuven 3000d, Belgium
³ Orthopaedic Surgery Department, Cairo University, Agouza Giza, Egypt

*Corresponding author: This email address is being protected from spambots. You need JavaScript enabled to view it.

Received: 3 February 2026
Accepted: 29 March 2026

Abstract

Introduction: Rotationplasty is a valid surgical technique in the management of bone sarcomas about the knee in children. This technique is often useful in patients with large extraosseous tumor extension and in the very young patients with anticipated significant limb length discrepancy. The aim of this study is to assess the long-term functional outcome and quality of life in our cohort of patients who have survived into adulthood. Methods: We have prospectively analyzed the functional outcome and quality of life in ten rotationplasty survivors. There were five male and five female patients with a mean age at the time of the index procedure of 11.6 ± 2.7 years. The functional outcome was evaluated using the Musculoskeletal Tumor Society Score (MSTS) and the Quality of Life (QoL) was assessed using the core quality of life questionnaire (QLQ-C30) of the EORTC. Results: Patients were followed up for a mean duration of 13.8 ± 4.4 years. The mean overall MSTS functional score was 82.7%. Nine patients reported either no or only minor functional restrictions. Only one patient used a crutch on walking for long distances, while other patients had unlimited or mild limitation of the distance that they could walk. The mean score of the global health status (QoL) was 85.8% with a mean score for social functioning of 90% and a mean score for role functioning of 88.3%. Conclusions: Rotationplasty affords the patients with an active lifestyle with no psychological or psychosocial disadvantages. The long-term assessment confirms that these patients maintain excellent functional results and quality of life through adulthood.