Rotationplasty

Synthesis, the magazine of UC Davis comprehensive cancer center, featured a 9-year-old boy who had sarcoma in his left knee and commissioned this explanatory illustration. Dr. Steven Thorpe undertook rotationplasty. This surgery removes the knee but spares the veins, arteries, nerves and healthy ankle. The ankle is then rotated 180 degrees and creates a new “knee joint”. In a child whose healthy knee is growing, this ankle-in-a-knee joint can keep up with its own innate growth plates. As the limb heels and prosthetics are fitted, the patient can still flex and extend the joint at knee level. This functionality is not preserved for those who chose above-the-knee amputations. Sadly many patients refuse rotationplasty because of the awkward appearance of the backwards foot. Amazingly, this surgery was first pioneered back in the 1940’s.