Medical Rehabilitation after Rotationplasty of the Lower Limb: A Narrative Review

Rotationplasty is a surgical procedure primarily used in cases of osteosarcoma and proximal focal femoral deficiency, offering an alternative to above-knee amputation, particularly in paediatric patients. Despite its unconventional aesthetic outcome, this procedure provides superior functional mobility and psychological well-being compared to traditional amputations. Postoperative rehabilitation plays a crucial role in optimising recovery and reintegration into daily life. Physiotherapy interventions, including active, passive, and proprioceptive neuromuscular facilitation techniques, contribute to joint mobility, muscular strength, and overall functional restoration. Additionally, scar mobilisation through cupping therapy and instrument-assisted soft tissue mobilisation (IASTM) reduces adhesions and enhances tissue flexibility. The rehabilitation process is structured into four phases: acute, subacute, early chronic, and late chronic. The acute phase prioritises limb protection and joint positioning, while the subacute phase focuses on increasing joint range of motion, core strengthening, and cardiovascular endurance. In the chronic phase, rehabilitation aims to restore functional movement, balance, and gait, ultimately facilitating a return to daily and sports activities. Electrotherapy is generally contraindicated due to patient age and the presence of metallic implants. A comprehensive, individualised physiotherapy programme significantly enhances post-rotationplasty recovery, improving quality of life and promoting independence. This paper underscores the importance of tailored rehabilitation strategies in maximising functional outcomes and long-term mobility following rotationplasty.