Rotationplasty, commonly known as a Van Nes rotation or Borggreve rotation
Rotationplasty is a surgery to amputate (remove) the middle part of your leg when there is a tumor near your knee. Your surgeon rotates the lower section of your leg (shin bone, ankle, and foot) 180 degrees. So, your foot points backwards. They reattach it to your remaining thigh bone. The ankle serves as a replacement knee joint. You wear a prosthesis (artificial limb) on your foot. Generally speaking, a rotationplasty leaves you with greater function than you would have with a standard amputation.
Rotationplasty is a very old concept. The original operation was the Van Nes rotationplasty. Newer modifications of this operation, first by Brown in 1996, and then by Paley in 1997, have made this an excellent alternative for the most severely deficient cases.
The Van Nes rotationplasty converts the ankle into a knee, and the knee is fused straight, and the hip is floating free. This type tends to rotate back partially, undoing the benefit of the rotationplasty; the Paley-modified Brown rotationplasty converts the knee into a hip and the ankle into a knee. The hip is very stable with this type because the small remnant of femur is fused to the pelvis. All of the original hip and knee muscles are reattached to operate the knee which becomes the new hip joint. The Paley rotationplasty connects the knee to the existing femoral head (when it is present) so that hip motion is produced by the combination of flexion of both knee and hip joints. Because the femoral head is connected, the hip can also abduct (move to the side) as well as rotate. This is not possible with the Brown rotationplasty. This gives a much better three-dimensional hip motion. The ankle again serves as the knee.