Objectives: This study aims to evaluate the diagnostic and prognostic significance of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) values in patients with osteosarcoma. Patients and methods: A total of 172 patients (111 males, 61 females; mean age: 24.3±15.3 years; range, 7 to 82 years) diagnosed with osteosarcoma in our institution between January 2002 and December 2018 were retrospectively analyzed. A total of 165 healthy individuals (115 males, 50 females; mean age: 20.2±9.2 years; range, 10 to 65 years) who did not have infectious, rheumatological or hematological diseases or any pathological finding were assigned as the control group. The clinical, laboratory, and demographic findings of the patients were obtained from hospital records. Pre-treatment NLR, PLR, and LMR values were calculated in all patients. Diagnostic and prognostic values of pre-treatment NLR, PLR and LMR were assessed using receiver operating curve (ROC) analysis. The Kaplan-Meier method was used for survival analysis. Results: For diagnostic approach, the highest significance in area under the curve (AUC) values was obtained for NLR (AUC=0.763). The AUC for PLR and LMR was statistically significant, while the statistical power was weak compared to NLR (AUC=0.681 and 0.603). The NLR, PLR, and LMR were found to be predictors of mortality. The cut-off value was found to be 3.28 for NLR, 128 for PLR, and 4.22 for LMR. The prognostic value of NLR for mortality was higher than (AUC=0.749) PLR (AUC=0.688) and LMR (AUC=0.609). The NLR, PLR, and LMR were associated with overall survival (OS). There was a significant difference in the median OS time among the NLR, PLR, and LMR values (log-rank test order p<0.001, p=0.001, and p=0.004, respectively). Conclusion: Based on our study results, pre-treatment NLR, PLR and MLR have diagnostic and prognostic values in osteosarcoma.

Cartilaginous tumors of the skeleton are amongst the most common; however, differential diagnosis remains to be a challenge. [1,2] These neoplasms range from enchondromas to chondrosarcomas with diagnostic margin being rather vague, particularly between enchondromas and low-grade chondrosarcomas where misdiagnosis may bring burdensome consequences. Currently, clinical discrimination mainly relies on location, radiologic, and pathologic properties of the tumor which yield little agreement between different clinicians for each patient. The need for a reliable and easily generalizable criteria is evident; however, there are no specific biomarkers available in the clinical setting despite ongoing studies. [3,4] Recent decade has seen many reports delivering evidence on the role of inflammation in the development and carcinogenic advancement of neoplasms, although pathways remain mainly unknown up to this date. [5,6] Therefore, blood-based markers of inflammation such as inflammatory cell counts and rates which are derived from those, 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<0.001). Neutrophil-to-lymphocyte ratio and MLR held diagnostic importance with statistically significant cutoff values. Statistically significant cutoffs for NLR and MLR were ≥2.0 (sensitivity=73.3%, specificity=67%) and ≥0.2 (sensitivity=76.2%, specificity=63%), respectively. Multivariate logistic regression analysis was performed adjusting for age and gender and NLR ≥2 [odds ratio (OR)=3.1] or MLR ≥0.2 (OR=2.9) were found to be associated with approximately threefold risk for diagnosis of enchondroma or low-grade chondrosarcoma. Conclusion: The NLR and MLR have diagnostic value in cartilaginous tumors such as enchondroma and low-grade chondrosarcoma. However, our results do not support utilization of NLR and MLR as diagnostic value for differentiation of enchondroma and low-grade chondrosarcoma.

No abstract

Osteoarthritis (OA) is a progressive and debilitating condition. [1,2] Varus deformity of knee joint increases the risk of progression of medial compartment OA. High tibial osteotomy (HTO) is a well-established surgical technique for individuals with medial OA and varus deformity. [3] The aim is to change the load distribution across the knee from the diseased medial part to the healthy lateral part in order to reduce pain, slow the degenerative process and delay the requirements for total knee replacement. [4] Osteotomy of the proximal tibia is becoming popular as compartmental OA of the knee is increasing in younger patients with malalignment of the joint. Open wedge high tibial osteotomy (OWHTO) on the medial side has been described as an effective surgical procedure in the treatment of medial compartmental OA. [5,6] Prevention of patella alta, easy correction of the deformity and no need for fibular osteotomy are the described advantages of medial sided osteotomy. Grafting the osteotomy site for quicker healing either with biologic resources or bone substitutes 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 nongrafted 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.

Primary benign and malignant bone tumors and metastases can be located in pelvic ramus. [1-4] In addition, non-tumor benign processes can be confused with tumor lesions. [5-7] Considering all tumors that settle in the ramus, although there are no data about the incidence of ramus tumors in the literature, chondrosarcoma (CS) is the most common tumor when the case reports are examined. [3,4,8-10] Also, the most common benign tumor is aneurysmal bone cyst (ABC). [11-14] Ramus tumors can be seen in a wide range of ages. [10,15] Patients usually present with symptoms of inguinal pain, swelling, or both. [2,15,16] Examination findings usually include a mass or sensitivity in that area. Some patients are detected by coincidental lesions on radiographs. [4,17,18] In almost all lesions, firstly, the lesion is detected by direct radiographs and further examinations are performed such as magnetic resonance imaging (MRI) or computed tomography. The treatment of tumors located in ramus varies according to tumor type. Follow-up, excision/curettage + adjuvant therapies or en-bloc resection can be performed in benign tumors. [2,4,6,15,16,19] In malignant tumors and metastases, wide resection (en-bloc resection of 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.