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a rotation plasti is a surgical procedure that provides an excellent option for patients with tumors in or near the knee joint it is best applied in children who are still growing during this procedure the surgeon removes the affected portion of bone along with the knee joint the major artery vein and nerve leading to the foot are saved the lower portion of the leg is rotated 180 degrees counterclockwise and then attached to the upper portion of the leg the ankle is now on the same plane as the former knee with the foot and toes pointing backward in the heel facing forward because of the rotation the ankle bends in the same direction as the knee the surgeon will take into account the age of the child and their growth potential initially the surgically modified knee center will be lower than the unaffected knee as the child grows and bones lengthen the knee centers will match in three to six months after the bones have healed the patient can be fitted for prosthesis the patients foot