Functional outcome of reverse shoulder tumor prosthesis in the treatment of proximal humerus tumors.

BACKGROUND: The treatment of proximal humerus tumors with reverse shoulder arthroplasty with allograft augmentation is still controversial. A tumor prosthesis represents a proven solution for such osseous defects. We investigated the functional results of patients who underwent reverse shoulder tumor prosthesis (RSTP) without the use of allograft after resection of a proximal humerus tumor. METHODS: We retrospectively evaluated 10 patients with malignant proximal humerus tumors who had undergone RSTP, with a mean follow-up period of 18.2 months (range, 6-27 months). The average age of the patients was 49.4 years. The mean resection length was 10.2 cm (range, 6-16 cm). The tumor prosthesis was preferred for the humeral component. Released rotator cuff muscles were reattached to the prosthesis with nonabsorbable sutures. RESULTS: The mean active forward flexion was 96° (range, 30°-160°), the mean active abduction was 88° (range, 30°-160°), and the mean active external rotation was 13° (range, 0°-20°). The mean Constant-Murley score was 53.7%. The mean Disabilities of the Arm, Shoulder, and Hand score was 26.2. The mean visual analog scale score was 1.3. The mean Musculoskeletal Tumor Society score was 78.1%. None of our patients have shown local recurrence or infection signs in the follow-up period. CONCLUSIONS: Functionally satisfying results and a stable shoulder can be achieved by reverse shoulder arthroplasty without the need for an allograft. An intact abductor mechanism with a shorter resection humerus length produced good results. The treatment of malignant proximal humerus tumors with RSTP is an alternative that minimizes surgery time and complexity.

Medium-term natural history of subacromial impingement syndrome.

BACKGROUND: We evaluated the factors that affect the natural course of subacromial impingement syndrome in patients without rotator cuff tears. METHODS: In total, 63 patients were included. During the first evaluation, we recorded each patient's age, gender, profession, body mass index (BMI), hand dominance, alcohol and tobacco consumption, comorbidities, causative event of pain, presence of a functional limitation, duration of symptoms, shoulder scores (American Shoulder and Elbow Surgeons [ASES], Constant-Murley, and visual analog scale), history of subacromial steroid injections, and magnetic resonance imaging (MRI) classification. A subacromial lidocaine injection test was performed to confirm the diagnosis, and patients were initially treated conservatively. Of the 63 patients, 7 underwent a subsequent surgical procedure. We recalled the patients and questioned them about recurrences. According to their answers, the patients were grouped as follows: group 1, no recurrence; group 2, relapsing course; and group 3, chronic course. We compared the groups regarding the factors proposed to affect the course of the disease. RESULTS: The mean follow-up time was 8.45 ± 0.9 years. There were no significant differences regarding gender, profession, hand dominance, alcohol consumption, smoking, comorbidities, causative event of pain, visual analog scale score, or history of subacromial steroid injections between groups. The patients in group 1 were significantly younger than those in group 2 (P = .038). The mean BMI value of the group 1 patients was significantly lower than that of the group 3 patients (P = .034). Patients with a functional limitation besides pain tended to have a relapsing course. The Constant-Murley and ASES scores were significantly higher for patients in group 1 than for patients in group 2 (P = .024 and P = .041, respectively). The duration of symptoms was significantly shorter (<3 months) in group 1 (P = .001). Most of the patients in group 1 had reversible changes on MRI (P = .038). CONCLUSION: In our study, younger age, lower BMI, more functional capacity, a shorter symptomatic period, reversible changes on MRI, and higher Constant and ASES scores at the first evaluation were good prognostic factors.

Results of displaced supracondylar humerus fractures treated with open reduction and internal fixation after a mean 22.4 years of follow-up.

BACKGROUND: The aim of this study was to evaluate the long-term functional and cosmetic results as well as the sagittal and coronal plane remodeling of displaced supracondylar humerus fractures treated with open reduction and internal fixation. METHODS: In total, 49 patients (11 boys and 38 girls) with Gartland type III supracondylar humerus fractures treated with open reduction and cross-pin fixation were retrospectively evaluated. The mean follow-up time was 22.4 years (range, 10.6-37.5 years). The Flynn criteria were used to assess the cosmetic and functional outcomes. Baumann's angle, the lateral rotational percentage, the humerus-elbow-wrist angle, and the humeral condylar angle were obtained from follow-up radiographs. The flexion and extension deficits compared with the uninjured side were measured at the last follow-up. RESULTS: According to the Flynn criteria, the cosmetic outcomes were satisfactory in 93.9% of the patients, and the functional outcomes were satisfactory in 83.7% of the patients. The average flexion deficit was 5° ± 8°, and the average extension deficit was 4° ± 5°. At the final follow-up, the mean difference in the humerus-elbow-wrist angle and the humeral condylar angle between the injured and uninjured sides was -4° ± 7° and 0° ± 3°. CONCLUSIONS: We identified the remodeling in the sagittal plane in supracondylar humerus fractures that had been united in flexion. Satisfactory functional and cosmetic results were obtained with the open reduction and internal fixation of displaced supracondylar fractures of the humerus, and no degenerative changes were observed at the long-term follow-up.

Rotational malalignment after closed intramedullary nailing of femoral shaft fractures and its influence on daily life.

BACKGROUND: Any intraoperative rotational malalignment during intramedullary nailing (IMN) of femoral shaft fractures will become permanent. We hypothesized that rotational malalignment of the femur and its compensatory biomechanics may induce problems in the hip, knee, patellofemoral and ankle joints. We purposed to clarify the influence of a femoral rotational malalignment of ≥10° on daily activities. METHODS: Twenty-four femoral shaft fracture patients treated with closed antegrade IMN were included. At last follow-up, to reveal any rotational malalignment, computerized tomography (CT) scans of both femurs (injured and uninjured sides) were examined. The patient groups with or without CT-detected true rotational malalignment ≥10° were compared with respect to the activity scores. RESULTS: Ten of the 24 patients (41.7%) had a CT-detected true rotational malalignment of ≥10° compared with the unaffected side. The AOFAS scores were 100.00 for all of the patients. LKS, WOMAC knee, and WOMAC hip scores were significantly decreased in the patients with rotational malalignment compared to those without. Patients without rotational malalignment tolerated climbing stairs significantly better than those with rotational malalignment. Patients who could not tolerate climbing stairs were consistently complaining of anterior knee pain. CONCLUSIONS: A femoral rotational malalignment of ≥10° is symptomatic for the patients, and the hip, knee, and patellofemoral joints were affected. Because of the possibly altered joint loadings and biomechanics, these could render patients prone to degenerative joint disease. In addition, due to the high rates of rotational malalignment after femoral shaft fracture and consequent malpractice claims, it is important for surgeons to be more aware of rotational alignment during surgery.

Intraoperative estimation of femoral anteversion in cementless total hip arthroplasty using the lesser trochanter.

INTRODUCTION: The intraoperative estimation of the anteversion of the femoral component of a total hip arthroplasty is generally made by the surgeon's visual assessment of the stem position relative to the condylar plane of the femur. AIM: The aim of this study was to evaluate the femoral component anteversion relative to lesser trochanter during cementless total hip arthroplasty. The intraoperative estimation of the anteversion of the femoral component of a total hip arthroplasty is generally made by the surgeon's visual assessment of the stem position relative to the condylar plane of the femur. The aim of this study was to evaluate the femoral component anteversion relative to lesser trochanter during cementless total hip arthroplasty. METHOD: The authors investigated the version of the lesser trochanter (LTV) relative to the posterior femoral condyles. Fifty-seven patients (59 hips) scheduled for primary cementless total hip arthroplasty underwent preoperative computed tomography and it was measured the LTV and collo-femoral version at the level of the proximal-most portion of the inferior neck, with respect to the lesser trochanter (native collo-trochanteric angle, NCTA). During surgery, the operative collo-trochanteric angle (OCTA) was measured. RESULTS: The mean LTV was 34.1 ± 3.0°, the mean NCTA was 49.1 ± 5.6°, and the mean OCTA was 48.8 ± 6.0°, which did not differ significantly from the NCTA (p = 0.495); the correlation coefficient was 0.872 (p < 0.0001). Based on the data, there was a constant relationship between the lesser trochanter and posterior femoral condyles and a good correlation between NCTA and OCTA. CONCLUSION: The authors recommend first estimating the anteversion of the femoral component relative to lesser trochanter and then adjusting the position of the acetabular component to that anteversion of the femoral component to improve stability and reduce impingement.

Predictors of mortality in elderly patients with an intertrochanteric or a femoral neck fracture.

BACKGROUND: We retrospectively analyzed 112 intertrochanteric femur fracture patients and 136 femoral neck fracture patients to determine mortality rates and factors affecting mortality. Internal fixation is the standard treatment method for intertrochanteric femur fracture patients in our institute, and arthroplasty, as a treatment choice, shows an increase in mortality rates. We wanted to convey if there was any decrease in mortality rate of intertrochanteric femur fracture patients when compared with femoral neck fracture patients who were almost always treated with arthroplasty. METHODS: Patients' age at admission, trauma date, delay until surgery, comorbidities, operation durations, anesthesia, and treatment types were evaluated by patients' folders. All preoperative and postoperative radiographs checked over for treatment type. Patients' recent health and activity status were determined by telephone interview. RESULTS: There were no significant differences in mortality rates between patients of two fracture types. Treatment type, anesthesia type, and sex were significant predictors in univariate analyses. In multivariate analyses, only age and delay in surgery identified as predictors of mortality, age was the most significant. Although intertrochanteric femur fracture patients were significantly older than femoral neck fracture patients, the estimated mean survival time was higher for intertrochanteric femur fracture patients (57.9 months) than for femoral neck fracture patients (48.8 months). CONCLUSION: We think that, in addition to the shorter delay in surgery, internal fixation choice led to decrease the mortality rate of intertrochanteric femur fracture patients. In conclusion, to decrease the mortality rate after hip fracture, since age and sex cannot be changed, needless delays in surgery should be avoided. Also, we recommend internal fixation and regional anesthesia to decrease the mortality rate.

Treatment of hallux valgus by modified McBride procedure: a 6-year follow-up.

BACKGROUND: Surgical decision-making was reevaluated by comparison with an algorithm designed to analyze treatment of hallux valgus deformities. MATERIALS AND METHODS: A modified McBride procedure was performed on 52 feet of 35 patients with hallux valgus deformity. From this series, 36 feet of 21 patients were evaluated preoperatively, early postoperatively, and late postoperatively by means of subjective evaluation and clinical and radiological findings. RESULTS: The hallux valgus angle preoperatively, early postoperatively, and late postoperatively was 32.7 +/- 8.5 degrees, 10.1 +/- 6.9 degrees, and 20.6 +/- 9.5 degrees, respectively. Hallux valgus recurrence of 72.2% was observed. Subjective results were better and the patients rated their satisfaction with the procedure as excellent or high in 23 cases (63.9%) and moderate, low, or unsatisfactory in 13 cases (36.1%). CONCLUSIONS: This level of patient satisfaction demonstrates that the McBride procedure is an efficient approach for eliminating pain due to hallux valgus deformity.

Outcome after the surgical treatment of the Dubberley type B distal humeral capitellar and trochlear fractures with a buttress plate.

OBJECTIVE: This study aimed to evaluate the functional outcomes of the surgical treatment performed with a buttress plate for the trochlear and distal capitellum fractures with posterior extension in the humerus. METHODS: The data belonging to 6 female and 4 male patients with a mean age of 43.8±11.1 (34-72) years were retrospectively evaluated. The mean follow-up period was 59.6±38.79 (22-127) months. The trochlear extension and posterior comminution of the fractures were assessed through the initial X-rays and computerized tomography images. Ten patients were classified as Dubberley type B. All fractures were treated surgically, with open reduction and internal fixation using a lateral buttress plate, headless cannulated screws, and Kirschner (K)-wires. The passive flexion and extension exercises were initiated at the first postoperative day. The patients were evaluated clinically and radiographically at the final follow-up. The outcomes were quantified using the Mayo Elbow Performance Index (MEPI), visual analog scale (VAS) pain score, and the patient's opinion. RESULTS: At the final follow-up, the mean elbow flexion was 137.5°±3° (132°-140°), extension was -17.9°±9.2° (10°-35°), pronation was 72.2°±2.6° (68°-75°), and supination was 78.9°±4.09 (72°-85°). The mean MEPI score was calculated as 95.5±5.98 (85-100). According to the MEPI score, 8 patients were evaluated as excellent and 2 as good. The mean VAS pain score was 0.8±1.03 (0-2). The subjective patient evaluation was recorded as excellent in 5 patients, good in 3 patients, and moderate in 2 patients. One patient developed avascular necrosis and 2 patients had elbow joint arthrosis. K-wire migration was observed in one patient. Loss of reduction, nonunion, malunion, reflex sympathetic dystrophy, or heterotopic ossification were not encountered. CONCLUSION: The management of distal humeral fractures is challenging, and favorable outcomes are closely associated with early joint motion. A solid fixation grants early mobilization. An internal fixation using lateral buttress plate, headless cannulated screws, and interfragmentary K-wires provides a solid and secure construction that allows early postoperative joint motion. LEVEL OF EVIDENCE: Level IV, Therapeutic study.

The coracoacromial ligament: the morphology and relation to rotator cuff pathology.

We dissected 80 shoulders from 44 fresh cadavers to define variants of the coracoacromial ligament and their relationship to rotator cuff degeneration. The shapes and the geometric data of the ligaments were investigated, and the rotator cuffs of the cadavers were evaluated macroscopically. Five main types of coracoacromial ligaments were found: Y-shaped, broad band, quadrangular, V-shaped, and multiple-banded. The Y-shaped ligament was the most frequent type, with a frequency of 41.3%, and the V-shaped ligament (11.2%) has not been previously reported. Of the cadavers that were dissected bilaterally, 64% showed the same type of ligament. There was no statistical significance between rotator cuff degeneration and the type or geometric measurement of the ligament. However, the coracoacromial ligaments with more than 1 bundle showed significant association with rotator cuff degeneration with a longer lateral border and larger coracoid insertion.

[Long-term results of total hip arthroplasty in patients with juvenile rheumatoid arthritis]. / Juvenil romatoid artrit hastaliginda total kalça artroplastisinin uzun dönem sonuçlari.

OBJECTIVES: We evaluated the long-term results of total hip arthroplasty (THA) in patients with juvenile rheumatoid arthritis (JRA). METHODS: The study included 37 hips of 23 patients (22 females, 1 male; mean age 22 years; range 17 to 30 years) who underwent THA for hip degeneration secondary to JRA. All arthroplasties were performed through an anterolateral approach by the same senior surgeon. The mean body surface of the patients was 1.5 m2 (range 1.1 to 1.7 m2) and the mean symptom duration to surgery was 12 years (range 7 to 16 years). Twenty-three hips received cemented, 14 hips received hybrid prostheses. In seven hips with an extremely narrow femoral medulla and shallow acetabulum, a CDH prosthesis was used. The hips were evaluated using the Harris hip score. Prosthetic loosening and displacement and heterotopic bone formation were assessed on follow-up radiographs. The mean follow-up period was 135 months (range 58 to 212 months). RESULTS: The mean Harris hip score increased from 27.2 (range 11 to 69) to 79.5 (range 37 to 87) postoperatively. At final follow-ups, all the patients were satisfied with the outcome and were able to walk without support. Three hips (8.1%; 3 patients) required revision. The overall Kaplan-Meier implant survival rate was 86.5%. There were no significant correlations between the Harris hip score and radiographic loosening and the presence of calcification around the prosthesis. Heterotopic bone formation of grade I was observed in 17 hips (46%). CONCLUSION: Even though it is performed at young ages, THA considerably improves quality of life of patients with JRA having hip joint involvement and has a comparable implant survival.

[Brachial plexus neuropathy (stinger syndrome) occurring in a patient with shoulder laxity]. / Omuz laksitesi zemininde gelisen brakiyal pleksus nöropatisi (stinger sendromu): olgu sunumu.

The stinger syndrome is a common neuropathy caused by traction or compression of the brachial plexus. In general, it is seen in young adults involved in sport activities and a major contact trauma is the rule. An 11-year-old boy with bilateral glenohumeral joint laxity had pain in the left shoulder, numbness and decreased strength in the left arm that developed after striking against a wall while running, with the left shoulder in extension and the neck in minimal lateral flexion to the contralateral side. Physical examination showed extreme anteroinferior passive translocation of the humeral head in neutral rotation and a positive sulcus sign in the left shoulder. The diagnosis was made as brachial plexus neuropathy (stinger syndrome) resulting from traction trauma and shoulder joint laxity and a shoulder-arm brace was applied. After two weeks, atrophy was detected in the right deltoid, supraspinatus, and infraspinatus muscles, and active and passive motion exercises of the shoulder were initiated. At the end of three months, he achieved normal range of motion of the shoulder and muscle strength.

[Isolated tuberculous tenosynovitis of the Achilles tendon: a report of two cases]. / Asil tendonunda izole tüberküloz tenosinovit: Iki olgu sunumu.

Tuberculous tenosynovitis involving the tendons of the feet is very rare. Isolated primary tuberculous tenosynovitis of the Achilles tendon was detected in two women aged 19 and 53 years, respectively. The younger patient had a swollen and painful Achilles tendon in the left foot. Complete excision of the lesion followed by antituberculous chemotherapy for six months resulted in complete improvement. Magnetic resonance imaging showed normal findings at the end of six months and no recurrence after 27 months of follow-up. The older patient had diabetes and was on cytostatic treatment for rheumatoid arthritis. She had difficulty in squatting and climbing stairs due to swelling and pain in the right ankle. She underwent abscess drainage and excision of the cystic mass. Despite disappearance of symptoms in the affected ankle in the course of antituberculous chemotherapy, she died due to miliary tuberculosis in the sixth month. Tuberculous tenosynovitis should be considered in the differential diagnosis of patients suffering from persistent swelling and pain in the hind foot.

Arthroscopic microfracture treatment for osteonecrosis of the knee.

PURPOSE: This study evaluated the results of arthroscopic subchondral microfracture performed on patients with spontaneous osteonecrosis (ON) (group 1) or secondary ON (group 2) of the knee joint. TYPE OF STUDY: Retrospective clinical study. METHODS: Group 1 included 26 patients (mean age, 48 years) who had spontaneous ON. Group 2 included 15 patients (mean age, 32 years) with ON secondary to inflammatory disease or steroid therapy. Seventy-six percent of the chondral defects were located in the medial femoral condyle. The average defect sizes in group 1 was 162 mm2 and in group 2 was 362 mm2. After debridement of the necrotic tissues, multiple perforations were placed into the subchondral bone to obtain revascularization. RESULTS: There was an increase in the average Lysholm scores from 57 to 90 in group 1 after 27 months of mean follow-up (P < .05); 71% of patients could participate in strenuous sports with no or minimal limitation. The mean activity level in group 1 according to Cincinnati Knee Rating System was 6 preoperatively and 13.54 postoperatively. For group 2, the average scores showed significant improvement and patient satisfaction after surgery (preoperative and postoperative average Lysholm scores were 41 and 75, respectively, with mean follow-up of 37 months). Average activity level in group 2 increased from 2.67 to 11.73. Control magnetic resonance imaging scans of the cases revealed the continuity of normal cartilage with cartilage-like tissue in the treated areas. However, an increase of the size of ON in the subchondral bone was detected in 27% of the knees. CONCLUSIONS: The microfracture technique is safe, simple, and cost-effective, and may be an alternative procedure for treatment of ON of the knee, especially in young patients, before possible subsequent replacement surgery. LEVEL OF EVIDENCE: Level IV.

[The evaluation and treatment of acute anterior shoulder dislocation]. / Akut anterior omuz çikiginin degerlendirme ve tedavisi.

Anterior shoulder dislocation is the most common dislocation in the human body with a high recurrence rate and thus, has been one of the interesting subjects in orthopaedics and traumatology. There is still controversy about its evaluation and treatment. In particular, the type and duration of immobilization after reduction of the shoulder vary among centers. Another matter of debate is the indication of acute repair of the capsulolabral structures to prevent late instability. This review aims to provide an outline of current knowledge about the management and treatment alternatives of anterior shoulder dislocation.

[Treatment of intertrochanteric femur fractures in elderly patients: internal fixation or hemiarthroplasty]. / Yaslilarda intertrokanterik femur kiriklarinin tedavisi: Internal tespit mi, hemiartroplasti mi?

OBJECTIVES: There is no consensus as to whether internal fixation or hemiarthroplasty is more appropriate for the treatment of intertrochanteric femur fractures in elderly patients. While the latter offers early mobilization, internal fixation preserves the hip joint and avoids long-term complications associated with the prosthesis. This retrospective study aimed to compare the early results of these treatment modalities. METHODS: The study included 81 patients who were available for follow-up after surgery for intertrochanteric femur fractures. Of 38 patients (mean age 77.7 years; range 65 to 99 years) treated with internal fixation, 25 were alive; of 43 patients (mean age 80 years; range 67 to 97 years) treated with hemiarthroplasty, 22 were alive at the last follow-ups. The two groups were compared with regard to perioperative characteristics, mobilization time, complications, mortality, and daily activities according to the Barthel Activities of Daily Living Index. The mean follow-up was 22.7 months (range 6 to 39 months) in internal fixation, and 22.3 months (range 7 to 39 months) in hemiarthroplasty groups. RESULTS: Subsequent to the operation, mortality occurred in 34.2% after a mean of 13 months (range 1 to 36 months) and in 48.8% after a mean of six months (range 1 to 24 months) in patients treated with internal fixation and endoprosthesis, respectively. There were no significant differences with respect to mobilization in bed, standing, weight bearing without support, complications, and daily activity scores. The only significant difference in favor of hemiarthroplasty was that full weight bearing with two crutches took a shorter time (p<0.05). CONCLUSION: Short-term results suggest that hemiarthroplasty is not an advantageous alternative to internal fixation; moreover, its postoperative survival is shorter and mortality rate is higher. Osteosynthesis seems to be the first choice in the treatment of elderly patients with intertrochanteric femur fractures.

[Radiologic evaluation of shoulder instability: conventional radiography, computed tomography and magnetic resonance imaging]. / Omuz instabilitesinde görüntüleme yöntemleri: radyografi, bilgisayarli tomografi ve manyetik rezonans görüntüleme.

Glenohumeral instability remains a very complex and sometimes challenging diagnostic problem. In most patients, the diagnosis relies mainly on history and physical examination. Radiologic studies provide further information about associated lesions. Although the initial imaging modality for any shoulder condition should be routine radiographs, additional imaging modalities are utilized to evaluate treatment options and prognosis. Computed tomography arthrography and magnetic resonance imaging provide valuable information. However, magnetic resonance arthrography may be required in cases in which it is uniquely appropriate for its multiplanar capability and excellent soft tissue contrast.

[Open surgical treatment of posterior instability of the shoulder]. / Posterior omuz instabilitesinin açik cerrahi tedavisi.

Posterior instability of the shoulder remains a diagnostic and therapeutic challenge, with a growing incidence especially in athletes. Evaluation of the type of the instability, whether unidirectional or multidirectional, is very important with regard to treatment. Although many patients benefit from strengthening and balancing rotator cuff muscles and scapular stabilizers, surgical procedures may be required in those unresponsive to conservative treatment. Posterior capsular shift is the method of choice to eliminate redundancy of the posterior and inferior capsules; moreover, in the presence of bone defects relating to the head of the glenoid or humerus, bony procedures should be added to the treatment.

Intra-articular hemangioma of the knee.

Intra-articular hemangioma of the knee is a rare cause of pain and spontaneous hemarthrosis, often seen as an internal derangement of the joint in children and young adults. The tumor is observed in two different forms: the synovial hemangioma or the arteriovenous malformation named also as hemangiohamartomas. They may cause hemorrhagic synovitis and arthropathy, probably as a result of recurrent episodes of intra-articular bleeding and mechanical irritation. Four cases of intra-articular hemangioma of the knee are presented in this study. Two of our cases were diagnosed as synovial hemangioma with the lesions localized inside the knee and the other 2 were intermediate type with the tumor extending to the muscle group and the skin. After magnetic resonance imaging and angiographic assessment, arthroscopic excision was performed in the localized type of the tumor. The other 2 cases received only diagnostic arthroscopy and biopsy followed by conservative treatment due to the extensive localization of the tumors and the serious chondral lesions. The decision of the treatment modality is very difficult in intra-articular hemangioma of the knee because, when combined with chondral degeneration, the incidence of local recurrence is high.

Medial meniscus anterior horn cyst: arthroscopic decompression.

Meniscus cysts are mostly seen with meniscus tears, and arthroscopic decompression of cysts is gaining great importance in their treatment. In this study, we present a medial meniscus anterior horn cyst without an accompanying tear in the meniscus. A 33-year-old male patient was seen with pain and a palpable mass in his right knee. He complained that the severity of the pain had increased over the previous year. After the clinical and radiologic examinations, a painless, fixed soft tissue mass averaging 4 x 5 cm was located just medial to tuberositas tibia. The cyst was decompressed arthroscopically. In the 18th month of follow up, the mass had totally disappeared and the patient had no pain. Medial meniscus cysts are seen nine times fewer than lateral meniscus cysts. They are mostly accompanied with meniscal tears. Total meniscectomy with arthrotomy, isolated cyst excision, cyst excision, and partial meniscectomy with arthrotomy and arthroscopic partial meniscectomy with cyst decompression are treatment modalities. Arthroscopic meniscal cyst decompression is an important treatment choice and should always be taken into consideration with low morbidity, short recovery period, low recurrence rate, preservation of range of motion, and permission for early mobilization and rehabilitation of the joint.