UNASSIGNED: We reviewed a total of 37 ankles (34 patients) that had undergone bone grafting for periprosthetic bone cysts. A CT scan was performed one year after bone grafting to check the status of graft incorporation. For accurate analysis of cyst volumes and their postoperative changes, 3D-reconstructed CT scan processed with 3D software was used. For functional outcomes, variables such as the Ankle Osteoarthritis Scale score and the visual analogue scale for pain were measured.
UNASSIGNED: Out of 37 ankles, graft incorporation was successful in 30 cases. Among the remaining seven cases, four (10.8%) exhibited cyst re-progression, so secondary bone grafting was needed. After secondary bone grafting, no further progression has been noted, resulting in an overall 91.9% success rate (34 of 37) at a mean follow-up period of 47.5 months (24 to 120). The remaining three cases (8.1%) showed implant loosening, so tibiotalocalcaneal arthrodesis was performed. Functional outcomes were also improved after bone grafting in all variables at the latest follow-up (p < 0.05). The mean incorporation rate of the grafts according to the location of the cysts was 84.8% (55.2% to 96.1%) at the medial malleolus, 65.1% (27.6% to 97.1%) at the tibia, and 81.2% (42.8% to 98.7%) at the talus. Smoking was identified as a significant predisposing factor adversely affecting graft incorporation (p = 0.001).
UNASSIGNED: Bone grafting for periprosthetic bone cysts following primary TAA is a reliable procedure with a satisfactory success rate and functional outcomes. Regular follow-up, including CT scan, is important for the detection of cyst re-progression to prevent implant loosening after bone grafting.
■我们回顾了37例(34例)因假体周围骨囊肿而接受骨移植的脚踝。植骨后一年进行CT扫描,以检查移植物掺入的状态。为了准确分析囊肿体积及其术后变化,使用3D软件处理的3D重建CT扫描。对于功能性结果,测量了诸如踝关节骨性关节炎量表评分和疼痛视觉模拟评分等变量.
■在37个脚踝中,30例移植成功。其余七宗个案中,4例(10.8%)出现囊肿再进展,所以需要二次植骨。二次植骨后,没有进一步的进展,在平均47.5个月(24至120个月)的随访期间,总体成功率为91.9%(37个中的34个)。其余3例(8.1%)为种植体松动,所以进行了胫骨关节固定术。在最新的随访中,骨移植后所有变量的功能结果也得到了改善(p<0.05)。根据囊肿的位置,移植物在内踝的平均掺入率为84.8%(55.2%至96.1%),胫骨占65.1%(27.6%至97.1%),距骨占81.2%(42.8%至98.7%)。吸烟被认为是对移植物掺入产生不利影响的重要诱发因素(p=0.001)。
■原发性TAA后假体周围骨囊肿的植骨是一种可靠的手术,具有令人满意的成功率和功能结局。定期随访,包括CT扫描,对于检测囊肿的再进展以防止植骨后植入物松动很重要。