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Case Reports in Orthopedics
Volume 2015 (2015), Article ID 241405, 5 pages
http://dx.doi.org/10.1155/2015/241405
Case Report

Rotationplasty with Vascular Reconstruction for Prosthetic Knee Joint Infection

1Division of Plastic and Reconstructive Surgery, National Cancer Center Hospital East, Chiba 277-8577, Japan
2Division of Plastic and Reconstructive Surgery, National Cancer Center Hospital, Tokyo 104-0045, Japan
3Division of Musculoskeletal Surgery, National Cancer Center Hospital, Tokyo 104-0045, Japan

Received 1 February 2015; Revised 20 March 2015; Accepted 24 March 2015

Academic Editor: John Nyland

Copyright © 2015 Masahide Fujiki et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Rotationplasty is used most often as a function-preserving salvage procedure after resection of sarcomas of the lower extremity; however, it is also used after infection of prosthetic knee joints. Conventional vascular management during rotationplasty is to preserve and coil major vessels, but recently, transection and reanastomosis of the major vessels has been widely performed. However, there has been little discussion regarding the optimal vascular management of rotationplasty after infection of prosthetic knee joints because rotationplasty is rarely performed for this indication. We reviewed four patients who had undergone resection of osteosarcomas of the femur, placement of a prosthetic knee joint, and rotationplasty with vascular reconstruction from 2010 to 2013. The mean interval between prosthetic joint replacement and rotationplasty was 10.4 years and the mean interval between the diagnosis of prosthesis infection and rotationplasty was 7.9 years. Rotationplasty was successful in all patients; however, in one patient, arterial thrombosis developed and necessitated urgent surgical removal and arterial reconstruction. All patients were able to walk independently with a prosthetic limb after rehabilitation. Although there is no consensus regarding the most appropriate method of vascular management during rotationplasty for revision of infected prosthetic joints, vascular transection and reanastomosis is a useful option.