Clinical Surgical Oncology (CSO) shared a post on LinkedIn:
“CSO HIGHLIGHT：Type B1 Rotationplasty for Post-Oncologic Femoral Osteomyelitis
When chronic infection, vascular compromise, and soft tissue loss follow sarcoma treatment, hip disarticulation is often the only perceived option. This case offers an alternative.
By the authors: G.G.J. Krebbekx / A.M.F. Vennik / L.E. Bröerken / Michael Bass, M.D. / D.T. Meijer / F.G.M. Verspoor
Background
A 40-year-old female with chronic femoral osteomyelitis, extensive soft tissue loss, and vascular injury after sarcoma resection, chemo, and radiotherapy.
Conventional limb salvage was no longer feasible.
Standard surgical recommendation: hip disarticulation.
Design and Innovation
A Winkelmann Type B1 rotationplasty was performed, integrating:
- Patient-specific cutting guides
- Intraoperative navigation (Brainlab)
- Multidisciplinary collaboration: ortho-oncology, vascular, and plastic surgery
This approach enabled precise osteotomies, optimal rotational alignment, and stable fixation – despite severely distorted anatomy.
- Core Findings (3-month follow-up)
- Infection controlled – CRP normalized (2.6 mg/L), no recurrence
- Limb preserved – hip disarticulation avoided
- Functional recovery – pseudo-hip flexion 90°; prosthetic fitting initiated
- Vascular success – infected graft removed, revascularization achieved
- tient-reported gains – improved mobility, hygiene, and quality of life
Takeaway
Type B1 rotationplasty, when executed with advanced technology and multidisciplinary expertise, represents a viable alternative to hip disarticulation in complex post-oncologic femoral pathology.
Early outcomes are encouraging – long-term follow-up is ongoing. ”
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