Long-term Follow up of Van Nes Rotationplasty for Congenital Proximal Focal Femoral Deficiency

Van Nes rotationplasty is a treatment option for individuals with congenital proximal focal femoral deficiency (PFFD), in which the extremity is surgically rotated to utilize the ankle and foot as a functional knee joint in a prosthesis. This case control study was done to determine the long-term function and quality of life (QOL) outcomes of these individuals. Twelve prosthetic participants (PFFD Group) and 12 control participants (Control Group) completed SF-36, Faces Pain Scale-Revised, Harris Hip Score, Oswestry back pain score and Prosthetic Evaluation Questionnaire© .Lower extremity physical exam, gait analysis, computerized dynamic posturography (CDP), and Timed ‘Up & Go’ testing was also completed. Wilcoxon Signed rank test used to compare each PFFD participant to the matched Control participant with false discovery rate of 5%. There were no differences between the Groups in overall health and well-being on the SF-36. Significant differences were seen in gait parameters in the PFFD Group. Using CDP, the PFFD Group showed decreased symmetry in stance, and reduced end point and maximum excursions. Individuals who underwent Van Nes rotationplasty showed a high level of function and QOL at long-term follow up, but presented with significant differences in gait and posturography parameters compared to the Control Group.