Quality of life in survivors with a Van Ness-Borggreve rotationplasty after bone tumour resection

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Abstract
In large malignancies of the distal femur, limb salvage may not be feasible. Amputation is often the treatment of choice. A Van Ness-Borggreve rotationplasty is an alternative when the sciatic nerve is free of tumour. The appearance of the rotated lower leg is poor, which justifies a general concern about the psychosocial functioning of these patients. The aim of the study was to assess the medium- and long-term effects on quality of life (QOL) after rotationplasty. A self-report questionnaire included the SF-36, the Social Support List, and selected items from the European Organisation for Research and Treatment of Cancer (EORTC) questionnaires as well as study-specific questions. The questionnaire was mailed to 34 patients at once. All patients were older than 16 years and at least 1 year postsurgery (mean 6.3 years). The response rate was 96%. Patients' physical functioning was poorer than that of healthy peers but better in comparison to chronically ill patients. Levels of psychosocial functioning, general QOL, and social support were highly comparable with those of healthy peers. One-third to one-half of the patients reported negative effects of the surgery on initiating social and/or intimate contacts, body image, and sexuality. With respect to physical functioning, two-thirds of patients engaged actively in sports. Patients reported wearing the prosthesis continuously and were, in general, satisfied with its fit. Given the relatively high levels of QOL and psychosocial functioning of these patients, these results indicate that rotationplasty is a good alternative in the treatment of patients with a large malignancy of the distal femur. J. Surg. Oncol. 2000;73:192–197.