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Background: COVID-19 pandemic has led to a difficult condition for healthcare providers to maintain their service without risking their safety. Generally, patients were canceling their hospital visits as they feared COVID-19 transmission. This has led to a general decline in the number of patient visits, attending doctors, and elective surgeries. However, this may not be the same for oncologic orthopedic cases which are allowed to continue elective surgeries, and the patients still perceive their condition as urgently in need of treatment. This article aimed to compare the number of oncologic orthopedic surgeries before and during the COVID-19 pandemic and describe the profile of oncologic orthopedic surgery two years of the pandemic.Methods: This was a retrospective study comparing the total number of oncologic orthopedic patients undergoing elective surgery in a single center, Prof. Dr. R. Soeharso Orthopedic Hospital, Surakarta, Indonesia, from March 2019 to February 2022. The number of surgeries per month before the pandemic, in the first and second years of the COVID-19 pandemic, was described and compared with one-way ANOVA. The surgical procedures performed in these three years were also described.Results: The total of oncologic orthopedic surgeries before the COVID-19 pandemic was 390 cases in comparison to 374 cases in the first year and 355 cases in the second year of the pandemic. The average number of cases per month was 32.5 ± 6.4 before the pandemic compared to 31.2 ± 7.8 in the first year and 29.5 ± 6.4 cases per month in the second year of the pandemic. There was no significant difference (p = 0.59, Confidence Interval 95%). Sophisticated reconstruction surgery such as arthroplasty and megaprosthesis still took place during the pandemic. Conclusions: The trend in the number of oncologic orthopedic surgeries did not decline significantly during the COVID-19 pandemic.

Background: Giant cell tumor is locally aggressive benign tumor that occur more common in distal femur, proximal tibia, and distal radius, and has tendency for recurrence and has capability for metastatize. Giant cell tumor in foot ankle are rare, and comprise less than four percent of giant cell tumor of the bone.Case Report: A 33 years old man presented with complains of pain and swelling in right ankle since 6 months ago with no history of trauma. Physical examination revealed increasing swelling over the distal-posteromedial aspect of lower leg and limitation ankle movements due to pain. Routine blood investigations showed slight increase of alkaline phosphatase. X-ray and Magnetic Resonance Imaging showed the lesion with morphology suggestive of giant cell tumor. Histopathology examination showed multinucleated giant cells and spindle shaped of mononuclear cells suggestive of giant cell tumor. The patient was treated with en-bloc-excision followed with distal tibial reconstruction using reverse intramedullary tibial nail combined with T-plate (tibio-talar arthodesis).Discussion: The main treatment of giant cell tumor of the bone is surgical removal to achieve tumor-free by eradication of the tumor, with various surgical techniques for reconstructing the cavity left. In this case we performed distal tibial reconstruction using reverse intramedullary tibial nail combined with T-plate.Conclusion: The patient at 12-month follow up is doing well, walking comfortably without any pain, has no limitation in range of motion with no signs of recurrence and good MSTS score (90).

Background: Magnetic Ressonance Imaging (MRI) is one of modality to diagnosed lumbar spinal stenosis (LSS) however there were some mismatch between the degree of canal stenosis to functional score of LSS. There are some methods to measure the degree of canal stenosis, on of them is Schizas Score. To asses functional score of patients with LSS, there are some tools can be used. Oswesstry Disability Index (ODI) and Neurogenic Claudication Outcome Score (NCOS) are questionnaire commonly used in LSS. This study aimed to analyze the correlation between the degree of stenosis grading using Schizas Score to the degree of disability using ODI score and Neurogenic Claudication using NCOS.