Psychological Well-Being, Self-Esteem, Quality of Life and Gender Differences as Determinants of Post-Traumatic Growth in Long-Term Knee Rotationplasty Survivors: A Cohort Study

Rotationplasty (RP) is a special surgical technique for bone tumors of the lower limb and is the chosen procedure for children under 6 with bone sarcoma in the distal femur. Leg reconstruction results in an unusual aspect of the limb potentially giving life-long emotional outcomes, especially considering the young age of most RP patients. Although the high level of the quality of life of these patients has been previously reported, aspects related to long-term psychological well-being, self-esteem and life satisfaction, particularly regarding the gender, procreation and parenting, have never been explored. The aim of this study was to assess the general degree of psychological well-being of RP patients, with specific reference to gender, procreation and parenting. Twenty long-term RP survivors of high-grade bone sarcoma participated in the study. They were administered the following validated questionnaires: HADS for psychological well-being (degree of anxiety and depression), Temperament and Character Inventory (TCI), RSES for self-esteem, SF-36 for quality of life, SWLS extended to life satisfaction, and ABIS for body image integration. Data on education, marriage, employment and parenthood were gathered. All the scores obtained were very close to normal references. The only gender difference was found for the TCI Cooperativeness scale, which was higher in women than in men. A satisfactory psychological well-being in terms of both self-esteem and integration of the prosthetic joint limb into one's body image, with relatively limited amount of anxiety/depression, good quality of life, and good temperament and character traits, was found. No major gender differences were reported.

Midterm follow-up of total hip arthroplasty in a patient with contralateral Van Nes rotationplasty for congenital proximal femoral focal deficiency

Total hip arthroplasty is a durable and effective operation in those with normal gait patterns. However, to our knowledge, there is no current literature on longevity in patients who have had a contralateral Van Nes rotationplasty for proximal femoral focal deficiency. We found evidence that patients who underwent rotationplasty have increased demands on the contralateral extremity and higher percentage of their gait cycle on the unaffected extremity. Here, we present a unique case report of a 59-year-old male patient with a 6-year follow-up status after left total hip arthroplasty and a right-sided rotationplasty performed during adolescence. Upon chart and radiograph review, we found no early signs of wear of his hip arthroplasty and a fully functioning lower extremity. In our limited experience, we found that total hip arthroplasty was a safe and durable operation for our patient who underwent a contralateral Van Nes rotationplasty at the 6-year follow-up period.

New Socket-Less Prosthesis concept facilitating comfortable and abrasion-free cycling after Van Nes rotationplasty

BACKGROUND AND AIM

Current leg prostheses in rotationplasty typically feature a thigh cuff, which, in cycling, may cause perspiration problems and friction-related abrasions of the skin. The aim has been to develop a socket-less prosthetic device for persons with a rotationplasty to be able to engage in high-intensity cycling without contracting abrasions.

TECHNIQUE

The new device (Socket-Less Rotationplasty Prosthesis for Cycling) features a standard cycling shoe on the rotationplasty foot, replacing the conventional socket and thigh cuff. A reinforced 12-layer carbon fibre frame bolted to the aforementioned shoe, replacing the standard tube, connects to a prosthetic foot and a second cycling shoe. Alignment of the Socket-Less Rotationplasty Prosthesis for Cycling is done both statically and dynamically.

DISCUSSION

The Socket-Less Rotationplasty Prosthesis for Cycling is lightweight and more ventilated relative to conventional sockets. All components can be replaced easily. Most important, however, is that the current user now can cycle 135 km on end without skin abrasions.

CLINICAL RELEVANCE

The Socket-Less Rotationplasty Prosthesis for Cycling concept enables patients with a leg rotationplasty to engage in high-intensity cycling without contracting skin problems, thereby facilitating clients' participation.