Outcomes Following Cyst Curettage and Bone Grafting for the Management of Periprosthetic Cystic Evolution After AES Total Ankle Replacement
BESSE ; LIENHARD ; FESSY
Type de document
ARTICLE A COMITE DE LECTURE REPERTORIE DANS BDI (ACL)
Langue
anglais
Auteur
BESSE ; LIENHARD ; FESSY
Résumé / Abstract
Bone cysts associated with total ankle replacement: Since 2008, severe medium-term cystic bone evolution was reported with AES total ankle replacement, inducing risk of mechanical complications. Curettage-grafting in periprosthetic cyst: The objective of the present study was to determine whether this technique provided a therapeutic solution, avoiding implant removal and arthrodesis. Results of the various grafts used: Iliac crest autograft, calcium phosphate cement, and polymethylmethacrylate cement were used. With a 79% functional and 92% radiological failure rate, our results in periprosthetic cyst grafting are poor. The principal surgical objective, of avoiding conversion to arthrodesis, failed in 28% of cases. Our present recommendations in evolutive periprosthetic cyst after total ankle replacement: We recommend annual radiological surveillance, with computed tomography (CT) in the case of increased cyst size and/or pain, so as to be able to suggest implant removal and reconstruction-arthrodesis before the talar component collapses. Onset of pain is generally related to microfracture induced by cortical lysis, detectable on CT ahead of implant migration.
Source
Clinics in Podiatric Medicine and Surgery, num. 2, pp. 157-170 p.
Editeur
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