Document Type




Format of Original

7 p.

Publication Date



British Editorial Society of Bone & Joint Surgery

Source Publication

The Bone & Joint Journal

Source ISSN


Original Item ID

doi: 10.1302/0301-620X.95B2.30853


Van Nes rotationplasty may be used for patients with congenital proximal focal femoral deficiency (PFFD). The lower limb is rotated to use the ankle and foot as a functional knee joint within a prosthesis. A small series of cases was investigated to determine the long-term outcome. At a mean of 21.5 years (11 to 45) after their rotationplasty, a total of 12 prosthetic patients completed the Short-Form (SF)-36, Faces Pain Scale-Revised, Harris hip score, Oswestry back pain score and Prosthetic Evaluation Questionnaires, as did 12 age- and gender-matched normal control participants. A physical examination and gait analysis, computerised dynamic posturography (CDP), and timed ‘Up & Go’ testing was also completed. Wilcoxon Signed rank test was used to compare each PFFD patient with a 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 had reduced symmetry in stance, and reduced end point and maximum excursions.

Patients who had undergone Van Nes rotationplasty had a high level of function and quality of life at long-term follow-up, but presented with significant differences in gait and posture compared with the control group.


Unedited, pre-publication draft. Reproduced with permission and copyright © British Editorial Society of Bone and Joint Surgery. Ackman J, Altiok H, Flanagan A, et al. "Long-term follow-up of Van Nes rotationplasty in patients with congenital proximal focal femoral deficiency." J Bone Joint Surg [Br] 2013;95-B:192-198. DOI. © 2012 American Academy of Orthopaedic Surgeons. Used with permission.