Endoscopic Treatment of Posteriorly Localized Talar Cysts

Purpose: This study presents the short-term follow-up results from our case series of patients with posteriorly localized intraosseous talar cysts. Patients were treated via hindfoot endoscopy in the prone position.

Methods: We evaluated six ankles of five patients treated with hindfoot endoscopy for intraosseous cysts localized to the posterior portion of talus. Three patients were men and two were women. The median age of the patients was 34 (22-40) years. The bilateral case was treated with a sole operation. The median preoperative AOFAS score was 69 (38-72) points. Additionally, all patients were found to have flexor hallucis longus (FHL) tendinitis in clinical and radiologic evaluations; large os trigoni were detected in five affected ankles. Debridement of scar tissue and FHL tendinitis, resection of os trigoni, and curettage and grafting of the cysts were completed endoscopically with one surgery. The cavities were filled with autografts in all patients except one. Hydroxyapatite was used in one case. The pathologic diagnoses were intraosseous ganglia in three feet and simple bone cysts in the remainder. The preoperative diagnoses were unchanged postoperatively.

Results: The median postoperative follow-up was 27 (12-74) months. In all patients, graft union was confirmed with computed tomography. The median AOFAS score improved to 90 (75-100) points postoperatively. There were no complications. All patients were satisfied with their results.

Conclusion: Hindfoot endoscopy can be used for the treatment of intraosseous talar cysts that are posteriorly localized. Significant advantages of this method include lower morbidity and shorter postoperative hospitalization time. Hindfoot endoscopy is a safe and effective method for treating talar cystic lesions and is an attractive option for experienced arthroscopic surgeons.

Level Of Evidence: IV.