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Objective: To evaluate the prognostic significance of neutrophil-to-lymphocyte ratio (NLR) in giant cell tumor of bone (GCT). Methods: The patients with GCT were identified in the hospital records and pre-treatment complete blood count results were acquired retrospectively. Whether preoperative NLR lymphocyte-to-monocyte ratio (LMR) and platelet-to-lymphocyte ratio (PLR) values had prognostic significance in predicting recurrence was evaluated by Receiver operating curve (ROC) analysis. Furthermore, the prognostic value of NLR was evaluated by Multivariable Cox Regression analysis. Results: There were 96 patients with GCT. It was found that only NLR values had prognostic significance for predicting recurrence (AUC:0.647; 95% CI:0.533-0.762; P=0.021). The statistically significant cut-off value of NLR for predicting re- currence was ≥2.25.NLR was ≥2.25 in 51% (n = 49) of patients. Multivariable analysis showed that NLR ≥2.25 (HR=2.9, 95% CI:1.3-6.6; p=0.009) and lung metastasis (HR=7.9, 95% CI:2.2-28.2; p=0.001) were independent factors of recurrence. In patients with lung metastasis and patients with NLR ≥2.25, recurrence was observed in a sooner period (Log rank test; p=0.001; p=0.009, respectively). Conclusion: Our findings showed that NLR is a new and promising inflammation-based prognostic factor in GCT patients. Keywords: Giant cell tumor of bone; neutrophil-to-lymphocyte ratio; prognostic significance.

Objectives This study aims to investigate the characterization and follow-up results of tumors and tumor-like lesions in the talus. Patients and methods Twenty-one patients (15 males, 6 females; mean age: 31.6±17 years; range, 4 to 67 years) with benign and malignant tumors or tumor-like lesions in the talus region treated and followed in our clinic between January 2007 and January 2019 were evaluated retrospectively. Radiological, pathological, surgical, and demographic features were scanned from the database. Results Patients were followed for mean 80±45.1 (range, 25 to 156) months. The most common complaint was pain and antalgic gait. Benign bone tumors were found in 15 (71%) of 21 patients, while tumor-like lesions (two intraosseous ganglia, osteomyelitis, and bone infarction) were found in four patients. The remaining two were patients with lung and bladder cancer metastasis. Lesion size was mean 2.1±0.5 (range, 1.1 to 3.3) cm. Recurrence developed in 14.3% (n=3) of the patients during follow-up. Conclusion The talus is a rare location for tumors; however, benign and malignant tumors and tumor-like lesions may be localized in the talus.

Objectives This study aims to investigate the diagnostic and prognostic role of mean platelet volume (MPV) and MPV/platelet (PLT) ratio in primary malignant bone tumors. Patients and methods We retrospectively investigated patients with primary malignant bone tumors between January 2010 and January 2019 and included 109 patients (69 males, 40 females; mean age: 41.9±17.9 years; range 15 to 86 years) in the study. A total of 107 healthy volunteers (61 males, 46 females; mean age: 47 years; range 19 to 61 years) who donated blood to the blood center of our hospital in 2019 formed the control group. Demographic features, MPV, PLT counts, mortality, and recurrence records of the patients were obtained from archives. Results Of the 109 patients, 11 were diagnosed with Ewing’s sarcoma, 52 with chondrosarcoma, and 46 with osteosarcoma. The tumor was located on the right in 56% of patients and on the lower extremity in 59.6% of patients. The recurrence rate was 41.3% in the patient group. Of the 109 patients, 17 (15.6%) resulted in exitus at follow-up. The mean PLT value of the patient group was significantly higher than the control group (289,440 vs. 247,299, p9.25 fL for MPV (sensitivity=74%, specificity=85%, positive likelihood ratio=4.96, positive predictive value=83.4%, and negative predictive value=76.5). Conclusion Consequently, MPV and MPV/PLT ratios can be used as a diagnostic support parameter in primary malignant bone tumors, but have no prognostic value.

Introduction: The Barthel Index of Activities of Daily Life (ADL) is a scale used to evaluate performance in daily life activities and investigate the reason and resulting relationships in a comprehensive, non-biased manner. Aim: The aim of this study was to compare the daily life activities of patients who underwent proximal femoral tumor resection prosthesis assessed by the Barthel Index with the activities of daily living of patients with a total hip prosthesis performed for non-tumor reasons. Materials and methods: Twenty-eight patients were included in the study. Sixteen patients underwent hip prosthesis for reasons other than tumor (femur proximal avascular necrosis, coxarthrosis, etc.) and 12 underwent wide resection and femur proximal tumor resection prosthesis due to primary malignant bone tumor or metastasis in the proximal femur. The Barthel Index was used to evaluate their life quality at 3 months. Results: A total of 28 patients (mean age 60.9±1.4 yrs, range 19.0-84.0, 17 female and 11 male patients) were included into the study. Mean ADL score was 84.5±20.6 (5–100.0). While only one patient was totally dependent in terms of daily life activities, 8 other patients were totally independent. When the patient groups were categorized by degree of dependency according to the ADL scores, it was found that dependency states of the two surgery groups were similar in distribution (p=0.212, p=0.703, and p=1.000 respectively). Conclusion: Functional recovering levels were good in the patients who underwent a surgery for proximal femoral tumor resection prosthesis; there was no significant difference when we compared the functional level after total hip prosthesis applied for non-tumor reasons.

Aim: The aim of this study is to investigate the diagnostic role of Neutrophil-to-lymphocyte ratio (NLR), Monocyte-to-lymphocyte ratio (MLR) and Platelet-to-lymphocyte ratio (PLR) in patients with lipoma and liposarcoma. Material and Methods: Patients operated for lipoma and liposarcoma at our institution between 2015 and 2019 were included in this retrospective study. A total of 92 patients with 44 lipoma and 48 liposarcoma were included in this study. The results of the complete blood count before treatment were retrospectively analyzed. 94 patients with complete blood count results admitted to the same center for reasons other than fracture, infection or tumors with similar age and sex to the aforementioned study group were included as healthy controls. Results: The average age of lipoma, liposarcoma and control groups included in the study was 55.3 ± 11.6, 48.9 ± 14.7 and 52.1 ± 11.7, respectively. While 50% of lipomas are located on the thigh and 40.9% are on the shoulder, 72.9% of the liposarcomas are located on the thigh. NLR values of the liposarcoma group were significantly higher than the control group. It was observed that PLR values did not differ significantly between groups. It was noted that MLR values were statistically significantly higher in the liposarcoma group than in the lipoma group. A significant but weak AUC value (AUC = 0.620, p = 0.020) was obtained for NLR. When the cut-off value and sensitivity, specificity, + LHR, PPV and NPV values of these cut off values are examined, NLR 1.83 and above values; It pointed out that his predictability was poor in the diagnostic approach for liposarcoma. Conclusion: Consequently, lipoma and liposarcoma are the most common forms of benign and malignant soft tissue tumors. NLR and MLR may be valuable in the diagnosis of liposarcoma, but more studies are needed in this regard.

Objectives: This study aims to evaluate the role of elevated neutrophil-to-lymphocyte ratio (NLR) and monocyte-tolymphocyte ratio (MLR) in differential diagnosis of enchondroma and low-grade chondrosarcoma. Patients and methods: One-hundred-and-one patients (44 males, 57 females; mean age 53.6±11.5 years; range, 21 to 85 years) diagnosed with enchondroma and low-grade chondrosarcoma in Ankara Oncology Training and Research Hospital between January 2010 and December 2019 were included in this retrospective study. Patients' age, gender, location and type of tumor, and pre-treatment complete blood count results were acquired. One-hundred patients (48 males, 52 females; mean age 50.9±13.6 years; range, 19 to 76 years) with complete blood count results admitted to the same center for reasons other than fracture, infection or tumors with similar age and gender to the aforementioned study group were included as healthy controls. Results: Neutrophil-to-lymphocyte ratio and MLR of the study group were found to be significantly higher than the control group (p

Objectives This study aims to investigate the characterization, treatment approaches, and follow-up results of tumors and tumor-like lesions located in the pelvic ramus. Patients and methods Thirty-one patients (9 males, 22 females; mean age 48.9 years; range, 7 to 79 years) with benign and malignant tumors or tumor-like lesions in the pelvic ramus region treated and followed-up in our clinic between January 2005 and January 2019 were evaluated retrospectively. Surgical procedures were performed with anterior approach or inner-thigh approach. Twelve patients were diagnosed with malignant tumors, 12 patients with benign tumors, and seven patients with tumor-like lesions. Results Seventeen patients who underwent surgical treatment were followed-up for a mean period of 61.7 months. The diameters of benign and malignant tumors were similar (p=0.425). Of all lesions, 64.5% were located in the pubis. Ischium location was significantly higher in patients with malignant lesions than tumor-like lesions. The most common complication was diffuse subcutaneous edema in the inguinal region and thigh (8.3%). Conclusion There are many different tumoral lesions in the pelvic ramus. Pelvic ramus tumors tend to settle more frequently in pubic ramus, whereas ramus ischium tumors are more likely to be malignant. In addition, the diagnosis of insufficiency fracture should be considered primarily in pathologic fractures of pubic ramus in females over 50 years of age. In the postoperative follow-up of pelvic ramus tumors, diffuse edema may occur even if there is no intraoperative vascular damage.

The aim of this study was to examine the characterization of tumors and tumor-like lesions located in the clavicle and to present their clinical results.Between January 2006 and December 2018, a total of 44 patients (25 males, 19 females; mean age: 36.2±21.8 years; range, 2 to 87 years) who were operated in our clinic for a clavicular lesion were included. Among 4,856 extremity tumors operated in our clinic between these years, 44 cases (0.9%) located in the clavicle were eligible. Demographic data, tumor types, location, surgical method, metastasis, survival analyzes and clinical results of these patients were reviewed retrospectively. According to the clavicle location, the patients were divided into groups according to their involvement in proximal, middle, lateral and more than one region.The most frequently involved site was the lateral edge of the clavicle, and the most common tumor was aneurysmal bone cyst. The most common malignant tumor was Ewing sarcoma and plasmacytoma (13.6%) and the most common surgical method in the clavicle was wide resection with 34.1%. Of the 38 primary clavicle tumors remaining after the metastatic lesions were removed, 21 (55%) were benign, while 17 (45%) were malignant. Aneurysmal bone cyst was most common in the group under 30 years of age, osteochondroma was most common in the 30-50 age group, and plasmacytoma was most common in those over 50 years of age. The mean musculoskeletal tumor society (MSTS) score of 15 patients (34.1%) who underwent clavicle resection was 79.4±6.We believe that a wide spectrum should be considered in the differential diagnosis of tumors located in the clavicle. Age is an important predictive factor for malignancy. We believe that resection should be applied without fear considering its effects on function and recurrence.

Background: Endobutton and Rigidfix are the most used fixation methods for anterior cruciate ligament reconstruction (ACLR). No studies were found investigating the superiority of these two methods to each other in terms of laxity, strength, gait and jumping.Aim: The purpose of this study is to compare laxity, tunnel enlargement, isokinetic strength, gait and jump in cases who had ACLR with Endobutton or Rigidfix techniques.Method: The study consisted of cases who received ACLR with Endobutton (n=13) and Rigidfix techniques (n=13). Bone tunnel enlargement was assessed on CT serial sections and anterior knee laxity was evaluated using an arthrometer. Quadriceps and Hamstring muscle strengths were measured using isokinetic system. BTS G-walk was used for gait analysis and jumping.Results: There was no statistically significant difference in anterior knee laxity, tunnel enlargement, isokinetic muscle strength and jump height between two groups. In gait analysis, only uninvolved side stride length and pelvic tilt symmetry index were significantly different between groups (p=0.045; p=0.038 respectively). Conclusions: In patients with ACLR, whichever type of fixation method was used; all of parameter values were similar. Furthermore, even after two years of surgery, functional differences were detected between the affected and unaffected legs. Also, statistically significant tunnel enlargement was found in both techniques. It was concluded that the recovery to normal condition after ACLR is not fully achieved, regardless of the fixation technique. It can be stated that this situation may cause problems in terms of the structure of the ligament and joint kinematics over time., Giriş: Endobutton ve Rigidfix ön çapraz bağ rekonstrüksiyonu (ÖÇBR) için en çok kullanılan tespit yöntemleridir. Laksite, kuvvet, yürüme ve sıçrama açısından bu iki yöntemin birbirine üstünlüğünü araştıran herhangi bir çalışmaya rastlanmamıştır.Amaç: Bu çalışmanın amacı ACLR olan olgularda endobutton veya Rigidfix teknikleri ile laksite, tünel genişliği, izokinetik güç, yürüme ve sıçramanın karşılaştırılmasıdır.Yöntem: Çalışmaya Endobutton (n=13) ve Rigidfix teknikleri (n=13) ile ÖÇBR uygulanan olgular dahil edildi. Kemik tünel genişlemesi BT seri kesitlerinde değerlendirildi ve ön diz laksitesi bir artrometre kullanılarak değerlendirildi. Quadriseps ve Hamstring kas kuvvetleri izokinetik sistem kullanılarak ölçüldü. Yürüyüş analizi ve sıçrama için BTS G-walk kullanıldı.Bulgular: İki grup arasında ön diz laksitesii, tünel genişlemesi, izokinetik kas kuvveti ve sıçrama yüksekliği açısından istatistiksel olarak anlamlı bir fark yoktu. Yürüyüş analizinde, sadece etkilenmemiş yan adım uzunluğu ve pelvik tilt simetri indeksi gruplar arasında anlamlı olarak farklıydı (sırasıyla p=0.045; p=0.038).Sonuçlar: ÖÇBR'li hastalarda hangi tip tespit yöntemi kullanılırsa kullanılsın; tüm parametre değerleri benzerdi. Ayrıca, iki yıllık ameliyattan sonra bile, etkilenen ve etkilenmeyen bacaklar arasında fonksiyonel farklılıklar tespit edildi. Ayrıca, her iki teknikte de istatistiksel olarak anlamlı tünel genişlemesi bulundu. Fiksasyon tekniğine bakılmaksızın ÖÇBR sonrası normal duruma dönmenin tam olarak sağlanamadığı sonucuna varıldı. Bu durumun zamanla bağın yapısı ve eklem kinematiği açısından sorunlara yol açabileceği ifade edilebilir.

Extraskeletal myxoid chondrosarcoma (EMC) is a rare soft tissue sarcoma. The aim of this study is to present the results of the patients we treated with the diagnosis of EMC as an oncology reference center.Information on 13 patients diagnosed with EMC between 2006 and 2018 was retrospectively reviewed. Patients' demographic information, tumor sizes, surgical treatments, chemotherapy and radiotherapy statuses, follow-up times, recurrences, and metastases were recorded.Mean patient age was 53.6 ± 15 years (range: 28-73). In 8 patients, the tumor was located in the lower limbs, most commonly in the thigh (46.2%). Mean follow-up period was 52.8 ± 19.9 (24-96) months. All patients underwent wide resections and only one had a positive surgical margin. In follow-up, 5 (38.5%) patients experienced recurrence; 6 patients had lung metastasis (46.2%) and 7 patients (53.8%) died. Mean tumor size was 10.4 ± 3.2 (5-17) cm. Median survival time was 61 (50.5-71.4) months and 5-year survival rate was 51.8%. There was no significant difference between survival times according to age, gender, side, limb location, postoperative radiotherapy, recurrence, or presence of lung metastasis. The cut-off value for death obtained by ROC analysis of tumor size was 11 cm.EMC is a rare soft tissue sarcoma with high local recurrence and metastasis capacity. Tumor size and metastatic disease are poor prognostic criteria. If it is a localized disease, the first option should be wide resection.

BACKGROUND: The aim of this study is to examine the effect of preoperative conservative treatment on the success of high-grade bursal/articular-sided partial rotator cuff repair. METHODS: Patients who had undergone shoulder arthroscopy in institution for Ellman Stage 3 bursal-side or articular-side partial tears between January 2008 and April 2018 were investigated retrospectively. This study assessed 201 patients diagnosed with isolated partial rotator cuff tears with a history of failed conservative management and persistent shoulder pain who underwent arthroscopic surgery. The demographic data of patients and pre- and postoperative The American Shoulder and Elbow Surgeons Shoulder Scores (ASES) that were recorded in the archive were evaluated. RESULTS: While 55 of the patients with Ellman grade 3 bursal-sided partial tears received preoperative conservative management for at least 6 months (Group 1), 62 of them could not tolerate conservative management and early arthroscopic repair was performed (Group 2). On the other hand, 42 of the patients with Ellman grade 3 articular-sided tears received preoperative conservative management (Group 3), 42 of them could not tolerate preoperative conservative management (Group 4). The mean ASES score improvement was 52.33 ± 8.55 for Group 1, 54.68 ± 11.29 for Group 2, 48.4 ± 7.77 for Group 3 and 49.33 ± 10.05 for Group 4. A statistically significant difference was found between the groups with one-way ANOVA test (p = 0.05). With the Tukey test, this difference was seen to be caused by Group 2. CONCLUSION: Although there are many factors affecting its success, conservative management should be the first option in the treatment of partial rotator cuff tears. However, we think that it should not be insisted especially in patients with bursal-sided tears (> 50% of the tendon thickness) that cannot tolerate conservative management due to severe pain since the results of early arthroscopic repair of bursal-sided tears were found to be better. LEVEL OF EVIDENCE: Retrospective comparative study, Level III.

Bu yazi, norofibromatozis (NF) ozellikleri olmayan bir multiple schwannoma olgusu raporudur. Hastane bilgi sistemi kayitlari ve hasta dosyasindan hastanin oykusu, fizik muayene bulgulari, radyolojik ve histopatolojik inceleme bulgulari incelendi. Hastanin ve ailesinin NF oykusu yoktu. Semptomatik lezyonlarin tumune total eksizyon yapildi. Histopatolojik inceleme, tum lezyonlari schwannom olarak dogruladi. Hastanin post-operatif on ikinci ayinda yeni lezyonu yok ve yasamindan memnundur. Norofibromatozis tip 2 ile iliskisiz olup, multipl lezyonlar seklinde ortaya cikan schwannomlar nadirdir. Yazarlar semptomatik lezyonlarda cerrahi eksizyon onermektedir.

Background: Accompanying injuries are frequently seen in middle aged patients with recurrent instability. The aim of this study was to elucidate the associated injuries, report patient outcomes of the following arthroscopic instability surgery regarding 40-60 years old patients with recurrent shoulder instability. Methods: Patients that underwent arthroscopic instability surgery due to recurrent shoulder instability between February 2008 and November 2015, and which were 40-60 years old were included and evaluated retrospectively. Minimum follow-up duration was 24 months. Anterior-inferior labral injuries and accompanying pathologies such as rotator cuff tears and SLAP lesions were documented. Postoperative patient-reported outcome evaluation was made using Oxford Shoulder Instability Score. Results: Among 355 patients that underwent arthroscopic instability surgery, 88 patients which had pathology of recurrent instability were in the range of 40-60 years old. Patients who had previous shoulder surgery or fracture (n = 8) epileptic seizure history (n = 3), neurologic deficit (n = 2) were excluded from the study. 75 patients were included with a mean follow-up 69 +/- 23 months (32-125). The percentage of middle-aged and elderly (40-60 years old) was 24.8% among recurrent shoulder instability patients. 44% had isolated Bankart lesion whereas 56% revealed multiple pathologies. Bankart + SLAP lesions were found in 32%, whereas Bankart + Rotator Cuff tears in 26.7% (13 isolated supraspinatus, 4 supraspinatus + subscapularis, 1 isolated subscapularis full-thickness and 2 partial thickness supraspinatus tears). The mean Oxford Shoulder Instability Score was 38.4 +/- 5.2 (26-48). The scores of patients which were treated with labrum and rotator cuff repair (median 42, range 30-48) were significantly better than the patients who were treated with isolated labrum repair (median 39, range 20-46) (p = 0.015). There was no difference regarding patients with or without SLAP repair (median 39 vs 39 and range 30-48 vs 20-48, respectively) (p = 0.702). Conclusions: Arthroscopic repair of capsulolabral lesions is a safe and successful technique in 40-60 years old patients. Furthermore, the presence of repaired rotator cuff tears led to even superior results. Accompanying SLAP lesions did not affect the results. Study design: Retrospective Case Series. Level of evidence: 4, Retrospective Case Series. (c) 2020 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

Introduction:Long head of biceps (LHB) pathologies are an important cause of pain and dysfunction. As LHB pathologies have specific components from other underlying or related pathologies, the LHB score is designed for an accurate assessment. The aim of this study was to adapt the LHB score into Turkish and to assess its validity and reliability.Materials and Methods:LHB score was translated and culturally adapted from English to Turkish, and then it was applied to 62 patients with biceps long head pathology. The reliability of the scale was checked through internal consistency and test–retest methods. Internal consistency was computed with Cronbach alpha value. Test–retest reliability was assessed using an intraclass correlation coefficient. American Shoulder and Elbow Surgeons Standard Shoulder Assessment Form and modified Constant–Murley score were used to analyze concurrent validity.Results:The Cronbach alpha value of the scale was found as .640. When the subsections of LHB score were computed separately, Cronbach alpha levels of pain/cramps and cosmesis sections were found as .753 and .774, respectively. The intraclass correlation coefficient value of the scale was found to be excellent (.940;P P P P Conclusion: The Turkish version of the LHB is a valid and reliable tool, especially for biceps pathologies.

Background Long head of biceps tendon (LHBT) instability is an important source of pain and disability for the shoulder. Supraspinatus and subscapularis tendons contribute to the formation of the biceps pulley system, which maintains biceps stability during shoulder movements. The aim of this study is to evaluate the effect of morphology of bicipital groove on the stability of LHBT. Also, to evaluate the relationship between bicipital groove morphology and subscapularis rupture and supraspinatus rupture. Material and methods Surgical images and magnetic resonance images of 200 patients who underwent shoulder arthroscopy surgery in our clinic between January 2016 and December 2017 were retrospectively analyzed. The depth of groove, medial wall angle and opening angle values of 200 patients were measured on MRI. The stability of the biceps long head tendon, rotator cuff tear and SLAP lesions was recorded by monitoring the shoulder arthroscopy records in each groups. Results There were 200 patients, 131 male and 69 female, with an average age of 40.9 +/- 14.2 (range: 17.0-79.0) years. In 69 (34.5%) patients, long head of the biceps tendon (LHBT) instability was detected. The patients were divided into two groups according to LHBT instability.The subscapularis rupture was significantly more frequent in the group with LHBT instability (52.2%) than the group without LHBT instability (4.6%) (p < 0.001). The supraspinatus tear was observed in 72.5% in the group with instability and 56.5% in the non-instability group, which shows a statistical difference between the two groups (p = 0.027). The presence of SLAP was observed in similar rates in both groups (p = 0.053). Mean depth of groove, medial wall angle, and opening angle measurements were similar in both groups (p = 0.568, p = 0.393 and p = 0.598, respectively). Conclusion To conclude, the morphology of the bicipital groove is not related to the stability of LHBT, and the soft tissue factors above the bicipital groove rather than bone morphology are important in stability. In addition, subscapularis rupture is a pre-disposing factor for LHBT instability; therefore, we recommend a more careful examination of LHBT in patients with subscapularis rupture.

Aim The aim of this study is to evaluate the risk of thromboembolic events and amount of postoperative blood loss and transfusion in patients who received preoperative tranexamic acid (TXA) administration in proximal femoral resection and endoprosthesis of proximal femur malignant lesion. Methods In this study, the data of 46 patients who underwent extensive resection and proximal femoral tumor prosthesis for proximal femoral bone malignancies were retrospectively reviewed. Patients were divided into two groups according to preoperative 15 mg/kg bolus intravenous administration of TXA. These patients were compared in terms of postoperative blood loss, postoperative bleeding, and transfusion requirements. Results There were 46 patients (18 female, 28 male) with a mean age of 60.7±14.7 (19-89) years. Fifteen patients (32.6%) were treated with iv TXA. In the TXA group (46.7%), there was a statistically significant decrease in the need for transfusion compared to the patient group (93.5%) without TXA (p=0.001). Postoperative 24th hour, 48th hour,and total drainage blood loss values were found to be significantly lower in the TXA group (p=0.047, p=0.015, and p=0.019, respectively). There was no thromboembolic event observed. Conclusion Because of proximal femoral malignancy, extensive tumor resection and preoperative bolus 15 mg/kg TXA administration in proximal femoral prosthesis surgery significantly decreased the amount of postoperative bleeding and transfusion requirement without increasing the risk of thromboembolic event. Level of evidence Level III - retrospective comparative study.

The aim of this study is to determine the treatment modalities and clinical characteristics of 12 patients diagnosed with giant cell tumor (GCT) of the hand and foot. The clinical findings, treatment modalities, and treatment failures of 12 patients with giant cell tumors of the hand and foot bones between 2007 and 2018 years were evaluated retrospectively. The average age at diagnosis was 29.2 ± 14.9 std. (between 16 and 62 years old), 8 males (66.6%) and 4 females (33.3%). Tumor was more frequently located in the talus, metacarpal, and metatarsal bones. The mean tumor size was 3.1 ± 1.1 cm (between 2.2 and 5.3 cm). The mean post-operative follow-up period was 76.3 ± 42.5 (between 12 and 139 months). The most of patients’ (58.3%) common complaints were pain. The most commonly used surgical method was curettage + autografting (91.7%). Infection was seen in one patient after relapse surgery. Recurrence occurred in 33.3% of the patients in the first year. Only one patient was detected to have knee and lung metastases. Swelling and pain in the hand and foot should be examined for tumor lesions. When a bone lesion is detected, the giant cell tumor of the bone should be included in the differential diagnosis. Patients with giant cell tumors should be followed closely for recurrence and metastasis after treatment.

Purpose To evaluate the clinical results of arthroscopic repair and open Ahlgren-Larsson method in patients with chronic lateral ankle instability. Methods We retrospectively evaluated 60 patients who were operated in our clinic between 2010 and 2018 with the diagnosis of chronic lateral ankle instability. Preoperative and postoperative clinical evaluations were performed with AOFAS ankle-hindfoot score, FAOS, and VAS scores. Results Sixty patients with chronic lateral ankle instability were evaluated. 28 patients were treated with Ahlgren-Larsson method, and 32 patients were treated with arthroscopic repair. Follow-up duration was 35 +/- 12 months for the open surgery group and 19 +/- 2 months for the arthroscopic surgery group. The mean age of the arthroscopy group was 44 +/- 9; the mean age of the open surgery group was 46 +/- 11. There was no significant difference between the groups in terms of demographic features (age, sex, BMI). Postoperative clinical improvement was observed in both groups. There was no statistically significant difference between the groups in terms of functionality. However, there was a statistically significant difference in VAS in terms of pain and patient satisfaction in favor of arthroscopy group. Conclusions Ahlgren-Larsson method and arthroscopic repair technique are safe and effective for chronic lateral ankle instability. Arthroscopic technique may be preferred for pain and patient satisfaction as it is less invasive and less morbid.

Introduction: Primary malignant tumours of the clavicle are exceptionally uncommon. In the literature the number of publications reporting long-term oncologic outcomes after claviculectomy is quite low. Aim: To analyse clinicopathological presentation of functional results of 15 patients with primary malignant clavicular tumour after claviculectomy and also to evaluate relationship of resection amount and the postoperative complication state with functional results. Materials and Methods: Fifteen patients (9 males, 6 females; mean age 44.8 years; range 2-87 years) with primary malignant tumours of clavicle who were performed claviculectomy between 2002 and 2017 were included the study. Patient’s mean follow-up duration was 41 months (range 14 to 68 months). Twelve patients underwent partial and 1 patient underwent total clavicle resection without reconstruction. Two patients underwent reconstruction with allograft fibula after partial clavicle resection. The functional result was assessed with the Constant-Murley scores, International Society of Limb SalvageMusculoskeletal Tumour Society (MSTS) evaluation system and The University of California-Los Angeles (UCLA) shoulder rating scale. Mann Whitney u test was used for comparison of data sets. Spearman correlation was used to test the association between resection amount and patient’s scale scores. Linear regression analyses were carried out to evaluate the association of resection amount with patient’s scale scores. Results: The mean postoperative MSTS score was 63.1±14.1 (range, 33-80), the mean Constant-Murley score was 57.8±13.7 (range, 30-74) and the mean UCLA score was 20.8±6.8 (range, 8-31). A statistically significant and perfect negative corelation was found between resection amount and MSTS score (r=-0.907 p

Amaç: Bu çalışmanın amacı, kliniğimizde kemiğin dev hücreli tümörü tanısı ile takip ve tedavi edilen hastalarda rekürrens ve akciğer metastazı arasındaki ilişkiyi değerlendirmek ve rekürrensi etkileyen diğer faktörleri sunmaktır.Gereç ve Yöntemler: Bu çalışma kesitsel tanımlayıcı tipte bir çalışmadır. Ankara Onkoloji Eğitim ve Araştırma Hastanesi Ortopedi ve Travmatoloji kliniğinde Ocak 2002- Aralık 2018 tarihleri arasında kemiğin dev hücreli tümörü nedeniyle tedavisi ve takibi yapılan hastalar retrospektif olarak taranmıştır. Tanı yaş ortalaması 31,6 ±13,3 (8-69) olan 52’si erkek 62’si kadın toplam 114 hasta çalışmaya dahil edilmiştir.Bulgular: Bu çalışmaya katılan hastaların ortalama takip süresi 63,1±33,4 (14-192) aydır. Hastaların %26,3’ünde ortalama 17,1 ayda (6-36 ay arası) rekürrens gelişirken, %4,4’ünde (5 hasta) akciğerde metastaz saptanmıştır. Rekürrens gelişen hastaların %13,3’ünde akciğer metastazı gözlenirken rekürrens gelişmeyenlerin %1,2’sinde akciğer metastazı gözlenmiştir. Rekürrens gelişen hastalarda rekürrens gelişmeyen gruba göre akciğer metastazı istatistiksel olarak anlamlı düzeyde daha fazla gözlenmiştir (p=0,017). Akciğer metastazının rekürrense kadar geçen süreler dikkate alınarak rekürrens gelişmesi üzerine olan etkisi Cox Regresyon analizi ile incelenmiştir. Akciğer metastazı için hesaplanan Hazard Ratio (HR): 12,8 (%95 GA:1,4-119,5; p=0,026) bulunmuştur.Sonuç: Kemiğin dev hücreli tümörleri, öngörülemeyen davranışları olan lokal agresif nadir metastaz yapan tümörlerdir ve en sık metastaz akciğerleredir. Çalışmamızda hastalar rekürrens durumlarına göre değerlendirildiğinde rekürrensi olan hastaların % 13,3' ünde, rekürrensi olmayan hastaların % 1.2' sinde akciğer metastazı gözlendi. Akciğer metastazı, rekürrens olan hasta grubunda rekürrens olmayan gruba göre anlamlı derecede yüksek bulunmuştur., Aim: The aim of this study is to evaluate the relationship between recurrence and lung metastasis in patients diagnosed with giant cell tumor of bone treated in our clinic and to present the other factors affecting the recurrence.Material and Methods: The patients who were treated and followed up for a giant cell tumor of the bone between 2002 and 2018 were retrospectively reviewed. A total of 114 patients with a mean age of 31.6 ± 13.3 were included in the study.Results: The mean follow-up period was 63.1 ± 33.4 months. Recurrence occurred in 26.3% (30 patients) of the patients in a mean of 17.1 months, while metastasis in the lung was found in 4.4% (5 patients). When the patients were evaluated according to their recurrence status, lung metastasis was observed in 13.3% of the patients with recurrence, while lung metastasis was observed in 1.2% of the patients without recurrence. Lung metastasis was found to be significantly higher in patients with recurrence than in the group without recurrence (p = 0.017). For lung metastasis, Hazard Ratio (HR) was calculated as 12.8 (95% CI: 1.4-119.5; p = 0.026).Conclusion: Giant cell tumors of the bone are locally aggressive tumors with unpredictable behavior. In our study, when the patients were evaluated according to their recurrence status, lung metastasis was observed in 13.3% of the patients with recurrence, and 1.2% of the patients without recurrence. Lung metastasis was found to be significantly higher in patients with recurrence than in the group without recurrence.

Objectives This study aims to investigate if iliac autogenous graft augmentation in medial open wedge high tibial osteotomies (OWHTOs) is superior to no augmentation in terms of bone healing. Patients and methods Twenty-five patients (14 males, 11 females; mean age 40.9±4.0 years; range, 33 to 48 years) with medial compartmental osteoarthritis of knee joint who underwent high tibial osteotomy with medial open wedge between January 2016 and December 2018 were included in this retrospective study. Twelve of the operated knees were the right knee. Graft was used in 13 patients (52%). Data including age, gender, body mass index (BMI), direction, follow-up period, union, Lysholm and International Knee Documentation Committee (IKDC) scores, pre- and postoperative femoral tibial angles (FTAs) and posterior tibial slopes were evaluated. Results The mean BMI was 26.4±1.9 (range, 22.0 to 30.0). Only 48% of the patients were smoking. The mean follow-up period was 28.6±5.3 months (range, 24 to 38 months). No statistically significant difference was found between the grafted and non-grafted groups in terms of age, BMI, follow-up time, gender, side and smoking status (p>0.05) There was no statistically significant difference between two groups in terms of pre- and postoperative Lysholm scores, pre- and postoperative IKDC scores, or pre- and postoperative FTA values (p>0.050). Conclusion Iliac autogenous graft augmentation in medial OWHTO has no effect on union but shortens the union time. Preoperative high varus degree adversely affects union. Therefore, routine use of iliac crest autograft is not recommended.

Congenital dislocation of the patella is a rare and difficult pathology to treat. We present a case of bilateral congenital dislocation of the patella with synostosis of proximal tibiofibular and proximal radioulnar joints without genu valgum deformity of both knees in a 30-year-old man. To our knowledge, congenital dislocation of the patella associated with synostosis of proximal tibiofibular and proximal radioulnar joints has not been reported in the literature yet.