DOS 2018

DOS Kongressen 2018 · 215 Bone grafting and talo-calcaneal fusion for huge talar cyst with STAR ankle replacement Johnny Froekjaer, Lasse Darling Andersen, Trine Torfing Orthopedic Surgical Department, Odense University Hospital; Radiological Departmen, Odense University Hospital Background: In Denmark the use of the STAR ankle replacement is dominant. Long term results show that cyst formation around the ankle replacement is a problem, potentially threatening the mechanical stability, causing loosening of components. Purpose / Aim of Study: The aim of our study is to present our results after treatment of big cysts under the STAR talar component with allogenous bone grafting and talocalcaneal fusion. Materials and Methods: Patients who earlier had a STAR ankle replacement, complaining of pain around the ankle were examined with radiograhs, and cystic lesions under the talar component were found. Evaluation of cyst number and size were done with a 3-D radiography - a weight bearing scan. Included in the study were patients, where cyst size and location were threatening mechanical stability of the component. Treatment was surgery with removal of all cyst con- tent, allogenous bone grafting through the talocalcaneal joint and fusion with headless compression screws. Histological examination was made of cyst con- tent. At follow up results were evaluated clinically and healing of bone grafting and fusion of joint with 3-D scan. Findings / Results: Twelve consecutive patients were operated, four females and eight males. Mean age at surgery was 59.9 years. Mean time from STAR to bone grafting and fusion was 6.2 years. Mean time from surgery to follow up was 33 months. Histology showed non specific inflammatory reaction. Nine patients had uneventful healing, with a good clinical result. Two patients had a nonunion, components were removed and a retrograde nail was inserted. Both healed with an acceptable clinical result. One patient had a severe postoperative deep infection and was treated with a bellow knee amputation. Conclusions: Treatment of talar cysts under STAR ankle replacement with bone grafting and talocalcaneal fusion gives a good result 156.