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.

[Autosomal dominant inheritance of congenital dislocation of the hip in 16 members of a family]. / Bir ailenin 16 üyesinde otozomal dominant kalitim gösteren gelisimsel kalça çikigi.

The effect of genetic factors on hip dislocation, acetabular dysplasia, and developmental dysplasia of the hip (DDH) has long been recognized. In this report, we presented a large family that showed single gene inheritance for DDH. Pedigree analysis of a pregnant woman revealed a history of DDH in 16 members of the family. Although the pedigree showed autosomal dominant inheritance with reduced penetrance, the prevalence of DDH was considerably high, almost accounting for one-third of the family members, and skipping only one generation. Of 16 cases, three patients were diagnosed at our center. The remaining 13 patients were diagnosed at other centers. Dislocation was diagnosed very late in most of the family members, while four cases were diagnosed at birth. All family members were informed by a detailed clinical letter and recommended evaluation for DDH at every birth.

Endoscopy-assisted periacetabular osteotomy: a preliminary cadaveric study.

Periacetabular osteotomy has been recommended for reconstructing symptomatic dysplastic hips in adolescents and young adults, but requires substantial incisions and exposure. To minimize large incisions, we asked whether periacetabular osteotomy could be performed with a mini-incision under direct endoscopic control. We used five fresh-frozen cadaver pelves and developed curved guides and osteotomes for the osteotomy. We were able to perform a periacetabular osteotomy under endoscopic and image intensifier control and to fix the osteotomy with two cannulated screws. We identified no damage to vital structures or intraarticular fracture in any of the five cadavers we subsequently dissected. We believe periacetabular osteotomy may be performed with a mini-incision under direct endoscopic control. Our preliminary observations suggest the approach might be explored in limited prospective clinical trials by experienced individuals.