Arthroscopic capsular release is more effective in pain relief than conservative treatment in patients with frozen shoulder.

Background: Frozen shoulder is a common medical condition, but the ideal therapeutic method is yet to be determined. Our aim was to analyze the pain-relieving effect of different treatment options used for the management of this disease.

Methods: Medical records of 59 patients (22 male, 37 female, average age: 55.

Current indications for denosumab in benign bone tumours.

Denosumab is a fully humanised monoclonal antibody to RANK ligand, inhibiting the RANK-RANKL pathway. It promotes the apoptosis of osteoclast-like giant cells, a secondary ossification and connective tissue formation. Given its high efficacy, denosumab is the standard treatment of unresectable or metastatic giant cell tumour of bone (GCTB) requiring morbid surgery.

Histomorphometric Analysis of 38 Giant Cell Tumors of Bone after Recurrence as Compared to Changes Following Denosumab Treatment.

Giant cell tumor of bone (GCTB) is an osteolytic tumor driven by an -mutated mononuclear cell with the accumulation of osteoclastic giant cells. We analyzed tissue from 13 patients with recurrence and 25 patients with denosumab therapy, including two cases of malignant transformation. We found a decrease in the total number of cells ( = 0.

The Activation of PDGFRβ on Mononuclear Stromal/Tumor Cells in Giant Cell Tumor of Bone After Denosumab Treatment. An Immunohistochemical Study of Five Cases.

Due to the relatively high recurrence rate and the destructive nature of the tumor, the treatment of giant cell tumor is still a challenge. Denosumab appeared to be a promising candidate as a therapeutic drug. However, several studies have reported that tumors can recur during/after treatment with denosumab.

[Our initial experiences with MR arthrography].

Introduction: The gold standard method for shoulder surgery imaging is magnetic resonance imaging (MRI). The sensitivity of the conventional MRI for full thickness tears is way above 85%, for partial rotator cuff lesions this number is less than 40%. Diagnostic accuracy is equally low in detecting different variations of anterior labrum lesion and also in injury of the glenohumeral ligaments.

[Prevalence of blood transfusion after primary total hip arthroplasty].

Total hip arthroplasty is one of the most common surgical procedures that requires blood transfusion, with the possible risk of significant complications. A retrospective study was performed to analyze the predictors of blood transfusion after primary total hip arthroplasty. We collected the data of 210 consecutive patients undergoing total hip arthroplasty.

[The role of multimodal postoperative analgesia after primary hip arthroplasty].

Due to the increasing number of arthroplasties, the number of post-operative hospital days was reduced and the rate of rehabilitation accelerated. For this, proper postoperative analgesia is essential and the multimodal pain relief is an excellent tool. The aim of our study was to compare postoperative functional results, postoperative pain levels, and opioid analgesic needs of patients who received conventional and novel analgesic treatments.

[Surgical treatment of a juxtaarticular bonecyst communicating with the ankle joint in a severe haemophilia A case].

The authors report the case of a 19-year-old male patient with inhibitor-positive factor VIII deficiency. The patient had painful, limited range of motion and swelling in the left toe, due to haemarthrosis 1-2 times a month. The MR images depicted a bone cyst penetrating into the tibiotalar joint space at the distal end of the left tibia.

[The change of fatty degeneration in the rotator cuff muscles after repair in patients over 65].

Introduction: In the case of rotator cuff tears, the severity of the muscle atrophy and fatty degeneration has an effect on the success of the repair and on the functional outcome after surgery.

Aim: The ability of regeneration reduces with ageing; therefore, the study examined the atrophy and the fatty degeneration after rotator cuff repair in patients over 65.

Method: Eleven patients over 65 years of age were involved whose surgery was performed at the Department of Orthopaedics of Semmelweis University between 2012 and 2015.

[Comparative functional outcome of reverse shoulder prostheses implanted on degenerative and oncological indications].

Introduction: Several methods (bone graft, endoprosthesis) are used to reconstruct proximal humerus resections due to primary and metastatic tumours. One of the new procedures is the replacement of the joint surfaces and the removed proximal humerus end with reverse shoulder prosthesis, optionally supplemented with bone implantation (composite procedure) in the hope of achieving better shoulder function.

Aim: The aim of this study was to compare the shoulder function of the patient group operated by the above procedure with reverse prosthesis to a patient group operated by indication of degenerative shoulder disease (rotator cuff arthropathy).

[Epidemiology of soft tissue sarcomas in a university center in Hungary].

Our aim was to investigate the rare malignant soft tissue sarcomas responsible for 1.5% of all malignant tumors, to compare our epidemiological data from the patient population of the Department of Orthopaedics, Semmelweis University, to data described in the international literature for soft tissue tumors. We reviewed 595 cases of primary soft tissue sarcomas treated between 1994 and 2014 and compared results to international data from the literature.

Diagnostic algorithm, prognostic factors and surgical treatment of metastatic cancer diseases of the long bones and spine.

Oncological management of skeletal metastases has changed dramatically in the last few decades. A significant number of patients survive for many years with their metastases.Surgeons are more active and the technical repertoire is broader, from plates to intramedullary devices to (tumour) endoprostheses.

[Change of paradigm in the surgical treatment of metastatic diseases of bone. Part I. Bony metastases of the extremities and pelvis].

According to the statistical data of tumor registries the incidence of cancer has increased in the last decade, however the mortality shows only a slight change due to the new and effective multimodal treatments. The aim of our overview article is to present the changes in the survival of the metastatic patients, and to demonstrate which factors influence their prognosis. The improvement of survival resulted in a more active surgical role both in metastases of the bone of the extremities and the pelvis.

[Periprosthetic joint infection caused by Rhodococcus equi. Case report].

Rhodococcus equi is a rare pathogen in humans causing infections mostly in immunocompromised hosts. We present the first case of periprosthetic joint infection caused by Rhodococcus equi. An 88-year-old male patient was referred to our clinic with a history of fever and right hip pain.

Prognostic impact of reduced connexin43 expression and gap junction coupling of neoplastic stromal cells in giant cell tumor of bone.

Missense mutations of the GJA1 gene encoding the gap junction channel protein connexin43 (Cx43) cause bone malformations resulting in oculodentodigital dysplasia (ODDD), while GJA1 null and ODDD mutant mice develop osteopenia. In this study we investigated Cx43 expression and channel functions in giant cell tumor of bone (GCTB), a locally aggressive osteolytic lesion with uncertain progression. Cx43 protein levels assessed by immunohistochemistry were correlated with GCTB cell types, clinico-radiological stages and progression free survival in tissue microarrays of 89 primary and 34 recurrent GCTB cases.

[Contemporary management of bone tumors at Semmelweis University].

The incidence of bone tumors is low therefore it is highly recommended to treat patients in specialized centers. In the late 70ies a bone tumor registry was initiated at the Department of Orthopedics of the Semmelweis University followed by the development of a specialized diagnostic unit and a bone cancer center. Several novel surgical procedures have been introduced, including the extremity-sparing surgery, leading to a significant improvement of the patients survival.

[Functional outcome of arthroscopic rotator cuff repair].

Introduction: Functional outcome after rotator cuff reconstruction is influenced by several factors of which re-rupture is probably the most important.

Aim: The aim of the study was to evaluate the postoperative outcome including re-rupture rate after arthroscopic rotator cuff reconstruction.

Method: 23 shoulders of 22 patients were examined prospectively.

[Limb saving surgery in cases of bone sarcomas].

At the Orthopedic Department of Semmelweis University we operate an internationally recognized bone and soft tissue tumor center. Our specialty is the treatment of benign and malignant bone tumors, tumor-like lesions and surgery of soft tissue tumors. Our main aim, taking into account the appropriate oncologic radicality, is to create the conditions for the development of limb saving surgery.

[Resection and reconstruction in cases of musculosceletal soft tissue sarcomas].

Soft tissue sarcomas are rare, reaching some 1.5% of all malignant tumors. While formerly the surgical management of sarcomas almost exclusively consisted of amputation, in the recent years limb saving surgery has become the first choice of therapy.

Epiphysis preserving resection of malignant proximal tibial tumours.

Purpose: The purpose of the study was to evaluate the treatment of five patients with proximal tibial epiphysis preserving resection for malignant tumours of the tibia.

Method: Three patients suffered from Ewing sarcoma, two had osteosarcoma. The proximal level of the resection was in the line of the growth plate in four patients, and 2 cm below of the growth plate in one patient.

[Midterm outcome after rotator cuff reconstruction].

Unlabelled: Rotator cuff tear is a common degenerative shoulder disorder that often requires surgical treatment. However, the correlation between the size of the tear and the functional results is somewhat controversial, which generates inconsistency among orthopaedic surgeons about the indications for and methods of rotator cuff reconstruction.

Aims: The aim of the authors was to evaluate the midterm functional outcome after rotator cuff reconstruction and the possible connection between the results and the surgical technique or the postoperative ultrasound examination.

[Results of the treatment of pediatric osteosarcoma in the Hungarian population].

The objective of this report was to estimate long-term outcome and prognostic factors in children and adolescents with osteosarcoma. To evaluate the efficacy of surgery and multiagent chemotherapy for treating osteosarcoma, we reviewed 122 cases (65 males, 57 females, mean age 13.8 ± 3.

Correlation between DNA ploidy, metaphase high-resolution comparative genomic hybridization results and clinical outcome of synovial sarcoma.

Background: Although synovial sarcoma is the 3rd most commonly occurring mesenchymal tumor in young adults, usually with a highly aggressive clinical course; remarkable differences can be seen regarding the clinical outcome. According to comparative genomic hybridization (CGH) data published in the literature, the simple and complex karyotypes show a correlation between the prognosis and clinical outcome. In addition, the connection between DNA ploidy and clinical course is controversial.

Good prognosis of localized osteosarcoma in young patients treated with limb-salvage surgery and chemotherapy.

Background: The objective of this report was to estimate long-term outcome and prognostic factors in children and adolescents with osteosarcoma. A large group of osteosarcoma patients were analyzed at our national oncology center.

Procedure: To evaluate the efficacy of surgery and multiagent chemotherapy for treating osteosarcoma, we reviewed 122 cases (65 male, 57 female, mean age 13.