Advanced arthroscopic ankle fusion-multicystic osteoarthritis 1
The extent and depth of mutli-cystic change is hinted at by the plain xray appearance. A Ct is usually wise pre-operatively to show the true extent of the bony defect. Especially when the cysts run deeply it is not pratical to resect the bone back to the level of the bases of the cysts. In doing so too much bone can be lost and compression is compromised by the intact malleoli and relatively large bone voids are left. Alternatively the cysts can simply be deroofed and contents curetted out. The sclerotic cyst bases are dealt with by drilling into them under direct vision with the guide wires on the screw set. Large cysts are packed with iliac crest bone graft.