Medial malleolar osteotomy for intralesional curettage and bone grafting of primary aneurysmal bone cyst of the talus

Trıpathy, Sujit Kumar; Varghese, Paulson; Panigrahi, Sibasish; Puthiyapura, Lubaib Karaniveed

doi:10.1136/bcr-2021-242452

Cited by 5 publications

(4 citation statements)

References 15 publications

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“…Due to the rarity of ABC of the foot, only case reports on the surgical treatment were published [1,5,6,12,[15][16][17]. One study describes a case series treated by percutaneous instillation of polidocanol or intralesional curettage [11].…”

Section: Discussionmentioning

confidence: 99%

Aneurismal bone cyst of the medial cuneiform bone: a case report of a new surgical approach and literature review

Leonchuk,

Punit

2023

jour

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Introduction An aneurysmal bone cyst (ABC) is a rare, non-neoplastic, destructive, hemorrhagic, and expansile lesion accounting for 1 % of all bone tumors. ABC of the foot is very rare. Patients with foot ABC usually complain of pain and swelling of the affected area. Radiographs and MRI may be helpful in the diagnosis of ABC. No single surgical procedure has gained wide acceptance in the treatment of foot ABC.Purpose To show new effective surgical approach in the treatment of patient with ABC of the medial cuneiform bone.Material and methods We present the case of a 47-year-old woman with a 10-months history of pain and swelling in her right foot. Postoperative histopathological evaluation of resected tissues confirmed the diagnosis of ABC. An en bloc resection (total extraction of the remnant of the medial cuneiform bone) was performed and the defect was replaced with a fibular bone graft from the right leg. Allograft (Bio-Ost®) was placed along the autograft. Tibialis anterior tendon was attached to the fibular bone graft. We performed fixation of the foot and ankle using the Ilizarov original apparatus for prevention of bone graft instability and opportunity for early weight-bearing on the operated foot.Results The postoperative period was uncomplicated with complete healing of the bone defect without recurrence after 12 months of observation. AOFAS score increased significantly from 34 points preoperatively to 92 at 1-year follow-up.Discussion The optimal treatment of this lesion is still under discussion. Different treatment modalities have been described in the literature: wide resection, curettage with or without adjuvants, arterial embolization, intralesional sclerotherapy. Biological reconstruction using bone graft seems to be the best option, but fractures and nonunion are common complications of bone grafting.Conclusion The combination of Ilizarov external fixation and bone grafting provided favorable conditions for the healing of foot bone defect due to ABC without complications, allowed mobility and early weight-bearing of the patient. Recurrence was not detected radiologically. Harvesting of the fibular bone graft did not affect the position of the foot and its movements. Our surgical approach should be considered as a treatment option in similar cases.

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Section: Discussionmentioning

confidence: 99%

Aneurismal bone cyst of the medial cuneiform bone: a case report of a new surgical approach and literature review

Leonchuk,

Punit

2023

jour

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“…22 It has also been scarcely used for the treatment of talus cysts other than IGC. 21 In this study, we evaluated the outcomes of the surgical treatment of the talus IGC through medial malleolus osteotomy. The objective and subjective functional outcomes of the patients were acceptable (96.3 and 94.5, respectively).…”

Section: Discussionmentioning

confidence: 99%

“…Various approaches, such as talonavicular joint and medial malleolar osteotomy, have been proposed for this purpose. 12,21 However, owing to its rarity, there is no clear consensus regarding the optimal surgical approach for these lesions and the outcomes of treatment as well. In this study, we aimed to evaluate the functional outcomes and surgical complications following the treatment of the idiopathic talus IGC with curettage and bone grafting through a medial malleolus osteotomy.…”

Section: Introductionmentioning

confidence: 99%

Intraosseous Ganglion Cyst of the Talus Treated With Curettage and Bone Grafting Through a Medial Malleolus Osteotomy

et al. 2022

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Background: Intraosseous ganglion cyst (IGC) of the talus is a rare entity. There is no consensus regarding the best surgical approach to the talus. In this study, we evaluated the outcomes of curettage and bone grafting of the talus IGC via medial malleolus osteotomy. Methods: Seventeen patients with talus IGC who were treated between 2002 and 2020 using curettage and bone grafting through a medial malleolus osteotomy were included. The outcome measures were ankle range of motion (ROM), pain, and function. The ankle pain was evaluated by the visual analog scale (VAS). The ankle function was evaluated by the Toronto extremity salvage score (TESS) and Musculoskeletal Tumor Society (MSTS) score. Results: The study population included 10 men and 7 women with a mean age of 34.9 ± 18.8 years and a mean follow-up of 5.4 ± 3 years. The mean size of the lesion was 2.6 ± 0.8 cm. Postoperatively, mean ankle dorsiflexion and plantar flexion were 19.4 ± 5.8 degrees and 36.7 ± 5.3 degrees, respectively. The mean VAS was 0.9 ± 1.1. The mean MSTS score and TESS were 96.2 ± 3.5 and 94.5 ± 4.1, respectively. Two patients developed ankle osteoarthritis after 3 years (1 stage I and 1 stage II). One of these patients (stage II) also had recurrence after 6 months (recurrence rate: 6.7%). Conclusion: Talus IGC could be adequately managed with curettage and bone grafting through a medial malleolus osteotomy. Even so, mild pain and reduced ankle ROM remain in some patients. Level of Evidence: Level IV, retrospective cohort study.

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“…Many surgical approaches have been advocated to treat symptomatic bone cysts. 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 Because the majority of the talar surface is covered with articular cartilage, open surgical approaches to the talar bone cysts frequently require extensive soft-tissue dissection, malleolar osteotomy, and damage to the talar articular cartilage. 1 , 2 Arthroscopic treatment of talar bone cyst is a feasible alternative minimally invasive approach to reduce the surgical trauma and eliminate the need of osteotomy.…”

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confidence: 99%

Arthroscopic Treatment of Bone Cyst of Anterior Half of the Talar Body

Tam¹,

Lui²

2022

Arthroscopy Techniques

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Medial malleolar osteotomy for intralesional curettage and bone grafting of primary aneurysmal bone cyst of the talus

Cited by 5 publications

References 15 publications

Aneurismal bone cyst of the medial cuneiform bone: a case report of a new surgical approach and literature review

Aneurismal bone cyst of the medial cuneiform bone: a case report of a new surgical approach and literature review

Intraosseous Ganglion Cyst of the Talus Treated With Curettage and Bone Grafting Through a Medial Malleolus Osteotomy

Arthroscopic Treatment of Bone Cyst of Anterior Half of the Talar Body

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