Good Quality of Life 3 Decades After Rotationplasty

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Abstract
Background: Long-term quality of life (QoL) after rotationplasty is important because prolonged patient survival has become more common. This study assessed QoL decades after rotationplasty. Methods: This cross-sectional study included surviving patients who had been treated for lower-extremity tumors, primaily sarcoma, between 1980 and 2002 at 2 Dutch centers. Patient-reported outcomes were assessed using the Short Form (SF)-36 Physical and Mental Component Summary (PCS and MCS) scores, Toronto Extremity Salvage Score (TESS), and Prosthesis Evaluation Questionnaire (PEQ). Functional status was assessed using the Musculoskeletal Tumor Society (MSTS) score. Results were compared with reference data from the general population and sarcoma survivors, and factors associated with better QoL outcomes were explored. Results: Thirty-three patients (mean age, 48.1 ± 8.9 years; mean follow-up, 32.8 ± 4.7 years) were included. Eighteen participants (54.5%) were female. The mean SF-36 PCS and MCS were 47.1 ± 10.4 and 52.2 ± 9.1, respectively. The mean TESS and MSTS were 88.2 ± 10.3 and 24.4 ± 5.4, respectively. Compared with a reference population with a history of lower-extremity sarcoma, patients who had been treated with rotationplasty scored higher on the PCS (p < 0.01) and TESS (p = 0.01). Only physical functioning was lower than in a general population (p = 0.01). Employment, relationship status, higher MSTS and TESS scores, greater satisfaction with prosthesis-related aspects of function and use on the PEQ, and greater overall satisfaction with rotationplasty were associated with higher PCS or MCS scores (p < 0.05). Conclusions: Rotationplasty appears to offer good long-term QoL outcomes and therefore remains a viable treatment option. Level of Evidence: Prognostic Level III . See Instructions for Authors for a complete description of levels of evidence.

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