Hip rotationplasty for malignant tumors of the proximal part of the femur.

Disarticulation of the hip and hemipelvectomy have been the only surgical alternatives available for the adequate local control of malignant tumors of the proximal part of the femur in patients who are still growing. The use of proximal or total femoral implants is restricted to patients who have reached skeletal maturity. To improve the quality of survival for patients who have not yet reached skeletal maturity and have a malignant tumor of the proximal part of the femur, I have modified the rotationplasty procedure described by Van Nes for use in such lesions. After en bloc resection of the tumor, the distal part of the femur with the knee joint and leg is rotated 180 degrees and fixed to the lateral side of the pelvis. The knee joint then functions as a hinge hip joint and the ankle joint functions as a knee joint. This procedure was performed in eight patients, three of whom were followed for more than two years. All patients walked well with a prosthesis and the functional results were excellent. At the time of writing, there had been no recurrence of a tumor or pulmonary metastasis.