A 6-year-old boy with osteosarcoma of the distal femur is being planned for limb salvage. The child is very young with significant growth remaining. Which surgical option provides a functional knee joint while allowing fitting of a below-knee prosthesis?
- A Van Nes rotationplasty ✓
- B Expandable endoprosthesis
- C Allograft-prosthetic composite
- D Arthrodesis with massive allograft
Correct answer: A. Van Nes rotationplasty
Explanation
Van Nes rotationplasty involves resecting the distal femur and rotating the lower leg 180 degrees, then fusing the tibia to the proximal femur. The ankle joint functions as a knee, enabling use of a below-knee prosthesis with excellent functional outcomes. It is preferred in very young children because expandable prostheses require multiple lengthening surgeries with high complication rates. Arthrodesis eliminates knee motion entirely. Allograft composites have high failure rates in skeletally immature patients.
Reference: Canale & Beaty, Campbell's Operative Orthopaedics, 13th ed.
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Written and medically reviewed by the StethoPrep medical team.