Removal of osteoblastoma of the talar neck using standard anterior ankle Arthroscopy：A case report

Duan, Xiaojun; Yang, Liu

doi:10.1016/j.ijscr.2016.03.013

Cited by 9 publications

(10 citation statements)

References 26 publications

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“…But in the recent 20 years, it has made astounding advances and been successfully used for osteochondral lesions of the talus, impingement syndrome, ankle arthrodesis, etc. [8–17]. However, there are very few reports on ankle TB treatment [2, 8–12], and arthroscopic management for early-stage ankle TB is even less reported.…”

Section: Introductionmentioning

confidence: 99%

Arthroscopic management for early-stage tuberculosis of the ankle

Duan

Yang

2019

J Orthop Surg Res

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BackgroundDue to atypical clinical presentation, wide use of antibiotics, and lack of specificity in diagnosis, diagnosis of tubercular (TB) infection in joints is increasingly difficult, and misdiagnosis is common. The use of arthroscopy for the diagnosis and treatment of early-stage ankle TB has rarely been reported. This case series intended to present the clinical outcomes of arthroscopic management for early-stage ankle TB.MethodsFifteen patients with chronic synovitis of the ankle and suspicious cause of early-stage ankle TB underwent arthroscopic treatment from April 1, 2010, to March 31, 2016. These cases all failed to confirm diagnosis of TB by ankle arthrocentesis. They included seven males and eight females with an average age of 37.5 (8 to 70) in the study. Among them, five cases had history of pulmonary tuberculosis, and six had history of trauma. The procedure included synovial membrane biopsy and debridement. The diagnosis was confirmed by pathologic examination and culture. The treatment was combined with systemic anti-tuberculous drugs. Follow-up measurements included VAS score, AOFAS score, ESR, CRP, and MRI.ResultsAfter arthroscopic management, 13 cases confirmed TB by pathologic examination and culture, and two cases still remained clinically suspected TB; the rate of confirmed case was 87%. The incision healed well in all cases, and no serious complications were observed. There were significant differences in VAS scores, AOFAS scores, ESR, and CRP between before and after treatment (P < 0.01). Joint swelling disappeared or was relieved after 2 months in most patients. Ankle swelling and pain in one patient was improved after changing anti-tuberculous drugs. MRI suggested that all patients had effusion in the articular cavity, accompanied by bone edema of the distal tibia and talus before the treatment. After the surgery, the effusion was significantly reduced, and the signal of bone edema almost disappeared. No recurrent TB was found during the follow-ups.ConclusionArthroscopic management for early-stage ankle TB is minimally invasive, safe, and reliable. It can easily obtain samples from specific area of TB for further confirmation of the diagnosis, while the debridement can also assist in local disease control. For cases of highly suspicious joint TB, arthroscopic biopsy and debridement after transient anti-TB treatment is recommended.Level of evidenceLevel IV, therapeutic case seriesElectronic supplementary materialThe online version of this article (10.1186/s13018-018-1048-y) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Arthroscopic management for early-stage tuberculosis of the ankle

Duan

Yang

2019

J Orthop Surg Res

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“…Ankle arthroscopy, which could reduce surgical trauma and offer a clear view, has become more and more popular in recent years (16)(17)(18). The arthroscopic method for treatment of talar cysts has also been given increasing attention (19)(20)(21)(22).…”

Section: Discussionmentioning

confidence: 99%

Arthroscopically Assisted Anterior Treatment of Symptomatic Large Talar Bone Cyst

Zhu

Yang

Duan

2019

The Journal of Foot and Ankle Surgery

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Symptomatic cystic lesions of the talus are rare. The traditional operations usually do not provide visualization to reveal the deep structure of the lesion and could cause cartilage damage or other severe traumatic injury. We report an operative technique to reach the cystic lesion without talar cartilage damage, remove the lesion, and fill defect with a bone graft assisted by anterior arthroscopy and evaluate its safety and reliability for future study. Seven cases of talar bone cyst were included. The patients were placed in the supine position after anesthesia induction and noninvasive ankle traction was applied. Standard anteromedial and anterolateral portals were established to observe the ankle; the distal end of the medial approach was moderately enlarged to 2 to 3 cm. The biopsy specimen of the cyst was obtained under arthroscopic guidance; the cyst wall was abraded and the sclerotic rim drilled. Arthrocare radiofrequency ablation was performed to prevent recurrence. The defect was tightly impacted with autologous or allograft cancellous bone. All cysts in these cases were located in the medial talus; anteroposterior radiographs and computed tomographic coronary scan showed a cyst diameter of >1 cm. Intraoperative inspection showed a tiny chondral gap on the talar dome in 1 case and on the medial wall of talus in 1 case; no cartilage injury was found in the remainder. Two cases were impacted with grafted autogenous iliac bone into the talar defect and 5 cases with allograft cancellous bone. Computed tomography confirmed that the cysts had healed, with no signs of recurrence found in any patient at 1 year postoperatively. The mean American Orthopaedic Foot and Ankle Society ankle-hindfoot scale score increased from 65 preoperatively to 91 points postoperatively, a statistically significant difference (p < .01). No complications developed and no reoperations were required postoperatively. Arthroscopically assisted anterior treatment with autologous or allograft bone graft is an effective method for symptomatic large talar bone cysts.

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“…For example, the incidence of talar bone cysts accounts for 0.003% of the bone tumor, and they are commonly diagnosed as simple bone cysts, aneurysmal bone cysts, intraosseous ganglion, etc. [1][2][3][4][5][6][7][8]. The etiology and mechanism of bone cysts have not been fully elucidated.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic Treatment of Symptomatic Foot and Ankle Bone Cyst with 3D Printing Application

Zhang

Cao

Zhu

et al. 2020

BioMed Research International

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Objective. To study the efficacy of arthroscopy for treating symptomatic bone cysts of the foot and ankle through the follow-up of patients and to further explore the application value of 3D printing technology in this treatment. Methods. Twenty-one patients with symptomatic bone cysts in the foot and ankle who underwent arthroscopic surgery in our Center from March 2010 to December 2018 were enrolled, including 11 in the experimental group and 10 in the control group. For the control group, C-arm fluoroscopy was used intraoperatively to confirm the positioning of the cysts; for the experimental group, a 3D model of the lesion tissue and the 3D-printed individualized guides were prepared to assist the positioning of the cysts. Debridement of the lesion tissues was conducted under an arthroscope. Regular follow-ups were conducted. The time of establishing arthroscopic approaches and the times of intraoperative fluoroscopy between the two groups were compared. Significance was determined as P < 0.05 . Results. The postoperative pathology of the patients confirmed the diagnosis. No significant perioperative complications were observed in either group, and no recurrence of bone cysts was seen at the last follow-up. The VAS scores and AOFAS scores of the two groups at the last follow-up were significantly improved compared with the preoperative data, but there was no statistical difference between the two groups. All surgeries were performed by the same senior surgeon. The time taken to establish the arthroscopic approaches between the two groups was statistically significant ( P < 0.001 ), and the times of intraoperative fluoroscopy required to establish the approach were also statistically significant ( P < 0.001 ). The intraoperative bleeding between the two groups was statistically significant ( P < 0.01 ). There was 1 case in each group whose postoperative CT showed insufficient bone grafting, but no increase in cavity volume was observed during the follow-up. Conclusion. With the assistance of the 3D printing technology for treating symptomatic bone cysts of the ankle and foot, the surgeon can design the operation preoperatively and perform the rehearsal, which would make it easier to establish the arthroscopic approach, better understand the anatomy, and make the operation smoother. This trial is registered with http://www.clinicaltrials.govNCT03152916.

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Removal of osteoblastoma of the talar neck using standard anterior ankle Arthroscopy：A case report

Abstract: HighlightsWe present the first, to our knowledge, case of osteoblastoma of the talar that was excised using standard anterior ankle arthroscopy.Osteoblastoma of the talar is rare.We present the first case, to our knowledge, that was excised using standard anterior ankle arthroscopy.

Cited by 9 publications

References 26 publications

Arthroscopic management for early-stage tuberculosis of the ankle

Arthroscopic management for early-stage tuberculosis of the ankle

Arthroscopically Assisted Anterior Treatment of Symptomatic Large Talar Bone Cyst

Endoscopic Treatment of Symptomatic Foot and Ankle Bone Cyst with 3D Printing Application

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