All Arthroscopic Decompression and Bone Grafting of Cyst in the Talus

A talar cyst is a fluid-filled sac in the talus bone, often caused by chronic stress fractures or traumatic injuries. A talar cyst if left untreated can result in chondromalacia of talus cartilage and ultimately arthritis. A timely intervention of cyst can have very good prognosis. An open cyst decompression and bone grafting is a standard procedure followed, but it is more invasive and sometimes involves medial malleolus osteotomy. If the same is done by arthroscopy, the morbidity of open procedure can be avoided.

A 34-year-old male complaining of pain in the ankle while walking for 3 months. There is no history of trauma. Patient has no rest pain. X-ray ankle anteroposterior and lateral shows a cystic lesion in the talus. An magnetic resonance imaging (MRI) was done which shows a cyst around 35 × 18 mm × 14 mm in the anteromedial talus. We preferred MRI over computed tomography scan as MRI gives the status of cartilage of tibiotalar joint along with cyst location and type of cyst also.

Arthroscopic cyst decompression is a good alternative to open decompression with less morbidity and speedy recovery. Patient selection is the key factor. This procedure is indicated for talar bone cysts associated with small osteochondral lesions or intact articular surface.