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Updated: May 8, 2026
Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
Published on: January 24, 2018
Long-term follow-up of 2 techniques to fill Total Ankle Replacement cysts: autograft and/or PCa substitute versus
Florian Voirin1, Conor Moran2, Marcelle Mercier3
1Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, Service de Chirurgie Orthopédique et Traumatologique, 69495 Pierre-Bénite Cedex, France.
Introduction:
Periprosthetic cysts are a frequent cause of Total Ankle Replacement (TAR) revision. Curettage and backfill is a common treatment for cyst formation. We have compared functional and radiological results for two types of backfill.
Materials And Methods:
This was a continuous, single-center, single-surgeon series of 32 TARs reoperated for cysts (22 AES, 10 Hintegra; 47% osteorathritis on laxity, 41% post-fracture; mean age at revision: 65.3 years) at a mean 6.4 years (2.4-14.5). Two types of filling were used successively: Group A - bone grafting, 7 cancellous autografts (May 2008-March 2009) and 4 calcium-phosphate substitutes (September 2009-April 2010), then, due to early cyst recurrence, (Group B) 21 PMMA-Genta cement (October 2010-May 2020). Lesion locations included 27 tibial, 26 talar, and 5 malleolar cysts. Patients underwent the same clinical, functional and radiographic evaluation (standard X-ray and CT scan).
Results:
Mean follow up was 7.1 years (1-16.7). One patient died in each group. There was a significant difference between groups, with 8 revision surgeries in group A (6 arthrodesis, 1 infection, 1 new PMMA graft) and 2 in group B (1 PE exchange for fracture and 1 cement debridement). Radiologically, the difference was significant at last FU. In group A, CT showed 100% cyst worsening (>25 mm); group B showed 79% good-quality cementing and/or interface radiolucency (1-2 mm), 4 cyst worsening, and 3 new cysts.
Conclusion:
PMMA cement filling achieved satisfactory clinical and radiological outcomes, with no secondary arthrodesis or prosthetic revision during follow-up.
Level Of Evidence:
IV.