Article
Operative Behandlungsstrategien periprothetischer Zysten nach Sprunggelenksendoprothetik
Search Medline for
Authors
Published: | October 10, 2016 |
---|
Outline
Text
Objectives: Total Ankle Replacement (TAR) has become an increasingly performed surgical procedure in recent years and provides an alterative to the long-standing gold-standard of arthrodesis for treatment of end-staged ankle arthritis.
Despite of good clinical results following TAR, the development of periprosthetic cysts (PPC) is a major source of concern.
The purpose of this study is to figure out different individual treatment options and short-term results for surgical managment of large and progressive PPC after TAR with the S.T.A.R.-(Scandinavian Total Ankle Replacement) device.
Methods: We retrospectively reviewed 17 patients with a mean age of 67,8 years (52-81 years) who underwent revision because of cyst enlargement and/or increased pain due to PPC and had been followed for a minimum of 6 months. The mean follow-up period was 31 months (6-68 months).
Results and Conclusion: Revision had to be performed at a mean time of 72 months (18-147 months) after primary TAR. Enormous PPC (>400mm2) were mostly found in the talus. Treatment options were cyst currettage with autologous spongiosa grafting and/or autologous bone grafts (ventral or dorsal iliac crest, depending on cyst-size) with or without screw-fixation. 4 patients underwent total revision arthroplasty (Hintegra revision replacement). This group of 17 patients had a mean range of motion of 32,5° postoperatively. X-rays and CT-scans mostly revealed in the short-term follow-up a good bone ingrowth. In 1 case a re-enlargement of PPC was found.
Despite of the short-term follow-up, this report should demonstrate different TAR-preserving treatment options for management of PPC before conversion in ankle arthrodesis as a salvage procedure is necessary.