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International Orthopaedics
Published in: International Orthopaedics 6/2018

01-06-2018 | Original Paper

Ganglion cysts of the proximal tibiofibular articulation: the role of arthrodesis and combined partial fibula excision

Authors: Gabriel Lateur, Regis Pailhé, Ramsay Refaie, Brice Rubens-Duval, Vincent Morin, Mehdi Boudissa, Dominique Saragaglia

Published in: International Orthopaedics | Issue 6/2018

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Abstract

Purpose

Cysts of the proximal tibiofibular articulation are rare and their optimal treatment remains unclear. The objective of this study was to evaluate the results and complications of the treatment of synovial ganglion cysts of the proximal tibiofibular articulation by simple excision or by excision and fusion of the proximal tibiofibular joint with a limited fibula excision.

Methods

Between January 2005 and December 2016, seven male patients with an average age of 46 years were treated for a ganglion cyst of the proximal tibiofibular articulation. Nine procedures were performed in total. Four patients underwent primary cyst excision, two underwent revision cyst excision and three underwent revision cyst excision with arthrodesis of the proximal tibiofibular joint and partial excision of the fibula (two patients underwent two procedures).

Results

Average follow-up was 79 months. The recurrence rate was 25% for simple cyst excision, 100% for revision cyst excision and 0% for cyst excision with arthrodesis. Average kitaoka score was 98 for simple cyst excision and 100 for cyst excision with arthrodesis (P = 0.34); resting visual analogue scores (VAS) were zero in both groups. With activity VAS was 0 for simple cyst excision and 1.6 in the arthrodesis group (P = 0.33). Two of the three arthrodesis patients went on to successful fusion. The third patient has an asymptomatic pseudarthrosis.

Conclusion

Simple primary cyst excision has a high failure rate at 25%. Revision cyst excision without fusion failed in all cases. We therefore recommend arthrodesis with limited fibula excision.
Appendix
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Metadata
Title
Ganglion cysts of the proximal tibiofibular articulation: the role of arthrodesis and combined partial fibula excision
Authors
Gabriel Lateur
Regis Pailhé
Ramsay Refaie
Brice Rubens-Duval
Vincent Morin
Mehdi Boudissa
Dominique Saragaglia
Publication date
01-06-2018
Publisher
Springer Berlin Heidelberg
Published in
International Orthopaedics / Issue 6/2018
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-017-3542-y

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