Objective: This study evaluated the clinical and radiological outcomes of patients with cystic osteochondral lesions of the tibial plafond (OLTP) treated with retrograde cancellous bone grafting.
Materials and Methods: A retrospective review was conducted on patients who underwent surgery for OLTP at our institution from 2012 to 2023. Eleven patients (7 females, 4 males; mean age 41.9 years) were included. Preoperative, intraoperative, and postoperative data were analyzed, including radiological assessments using direct radiography, CT, and MRI. The surgical technique involved retrograde cancellous bone grafting, with postoperative rehabilitation and follow-up evaluations using the AOFAS score.
Results: The mean clinical follow-up period was 75.7 (median: 79, range: 12-137) months. The mean preoperative AOFAS score improved significantly from 56.0 to 89.3 (p=0.003). Radiological follow-up showed cyst consolidation in seven patients, while four experienced recurrences (36.3%). Recurrence was associated with persistent communication between the cyst cavity and the joint space.
Conclusion: Retrograde cancellous bone grafting significantly improves clinical outcomes in patients with cystic osteochondral lesions of the tibial plafond, as demonstrated by a marked increase in postoperative AOFAS scores compared to preoperative values. However, a high recurrence rate of 36.3% highlights the need for advancements in surgical techniques to achieve complete healing. Successful outcomes hinge on the effective obliteration of the communication between the cyst and the ankle joint space.