Rotationplasty Rehabilitation Protocol: A Complex Case Report
Bibliographic record
Abstract
Background and Purpose: Rotationplasty is a rare, complex limb salvage surgery that creates opportunity for physical therapists to develop a unique rehabilitation plan focusing on functional mobility and independence. To date, there is no comprehensive rehabilitation-specific protocol documented in the literature for individuals who have undergone rotationplasty. This case report describes the first novel comprehensive rehabilitation protocol, interventional strategies, and optimal functional outcome of a patient who underwent rotationplasty. Case Description: The patient was a 20-year-old man with a history of high-grade osteosarcoma of left distal femur who underwent numerous limb-sparing procedures resulting in pain and debility necessitating rotationplasty. Rehabilitation protocol and focused physical therapy interventions were implemented pre- and postsurgery based on functional limitations. Outcomes: The Toronto Extremity Salvage Score (TESS), Musculoskeletal Tumor Society (MSTS) assessment, Timed Up and Go (TUG) test, range of motion, and strength testing of the affected lower extremity all demonstrated significant improvement from prerotationplasty to postsurgery to 1-year follow-up. A 41.8% improvement in TESS outcome was found from postsurgery to 1-year follow-up. MSTS assessment showed a 60% improvement from presurgery to 1-year follow-up. TUG score improved by 0.7 seconds with no assistive device by final discharge. The patient met all therapy goals and reported no functional limitations at discharge. Discussion: Implementation of a rehabilitation protocol for this unique population guides clinicians' decision making while developing congruency between providers. This protocol paired with targeted interventions promotes successful patient outcome and aids as a framework for clinicians to be used in treating this complex patient population.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.003 | 0.002 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.005 | 0.003 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".