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Arthroscopic Debridement of a Talar Cyst and Bone Grafting with the Osteochondral Autograft Transfer System

A Case Report

Nobuaki Chinzei Kobe University Graduate School of Medicine, Kobe, Japan.

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 MD, PhD
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Noriyuki Kanzaki Kobe University Graduate School of Medicine, Kobe, Japan.

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 MD, PhD
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Takaaki Fujishiro Kobe University Graduate School of Medicine, Kobe, Japan.

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Shinya Hayashi Kobe University Graduate School of Medicine, Kobe, Japan.

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Shingo Hashimoto Kobe University Graduate School of Medicine, Kobe, Japan.

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Ryosuke Kuroda Kobe University Graduate School of Medicine, Kobe, Japan.

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Masahiro Kurosaka Kobe University Graduate School of Medicine, Kobe, Japan.

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Simple bone cysts compose approximately 3% of all primary bone tumors and most commonly occur in the metaphyseal regions of the proximal humerus and femur. The percentage of the talus with suspected bone tumors is reported to be 0.003%. Therefore, talar cysts are rare but sometimes present as aggressive lesions, and they can affect any of the tarsal bones. Recently, an arthroscopic approach to these lesions has been developed that is less invasive than conventional open surgery. In the present case study, we profile a 65-year-old female patient who received arthroscopic debridement of a bone cyst from the medial aspect of the talus with the osteochondral autograft transfer system (OATS). By using the OATS core harvester, we penetrated into the tumor. After the cylindrical bone plug was pulled out, the tumor was removed and artificial bone granules were firmly packed into the cavity with intralesional arthroscopy. Then, the cylindrical bone plug previously harvested by OATS was implanted at the site with careful precision. This intervention resulted in a relative restoration of talar dome anatomy and ultimately restored the patient to activity with minimal discomfort. Therefore, arthroscopic debridement with OATS has the potential to be a useful option in dealing with debilitating osteochondral cystic lesions.

Corresponding author: Noriyuki Kanzaki, MD, PhD, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan. (E-mail: kanzaki@med.kobe-u.ac.jp)
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