{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:47:32Z","timestamp":1788223652201,"version":"build-2803163510"},"reference-count":23,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2015,10,1]],"date-time":"2015-10-01T00:00:00Z","timestamp":1443657600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Foot Ankle Int."],"published-print":{"date-parts":[[2016,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The operative treatment of bone cysts after total ankle replacements (TAR) is not well described. Bone cysts may cause component migration, implant failure, and pain. Surgery is performed on cysts with the goals of reducing pain and preventing component failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We retrospectively evaluated a consecutive series of 726 primary TARs performed between January 1998 and May 2013 and identified those who had a subsequent bone cyst grafting procedure. We identified cyst location and method of treatment. Clinical outcomes including secondary procedures, infection rate, complications, and failure rate were recorded. Thirty-one patients were treated with a total of 33 operative procedures for bone cysts after TAR. Of these patients, 22 (71.0%) were males with an average age of 62.2 and median follow-up 65.9 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Intraoperatively, 22 tibial cysts (71.0%), 20 talar cysts (64.5%), 5 fibular cysts (16.1%), and 13 multiple cysts (41.9%) were treated. Allograft was used in 25 procedures (75.8%), calcium phosphate in 4 (12.1%), cement in 3 (9.1%), and autograft in 1 (3.0%). These procedures were supplemented by calcaneus autograft, allograft mixed with mesenchymal stem cells, platelet-rich plasma, recombinant human bone morphogenic protein-2, and demineralized bone matrix. There were no infections or wound complications. Of the 27 subjects with a successful second surgery, the success rate for bone grafting of cysts was 90.9% (95% CI: 50.8, 98.7%) at 24 months and 60.6% (95% CI: 25.1%, 83.4%) at 48 months. One patient needed a repeat bone grafting. The 4 failures observed postprocedure resulted in 3 tibial and talar component revisions, and 1 tibiotalocalcaneal (TTC) fusion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Grafting bone cysts without revision of TAR was in general an effective and safe means for treating patients with peri-prosthetic bone cysts. Treatment with grafting and supplemental materials may improve implant survivorship and might improve the structural support surrounding the implant. Further exploration of the etiology of bone cysts may aid in the prevention and treatment of cystic formation in the TAR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>Level IV, case series.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1071100715609055","type":"journal-article","created":{"date-parts":[[2015,10,1]],"date-time":"2015-10-01T23:44:39Z","timestamp":1443743079000},"page":"157-164","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":48,"title":["Outcomes of Bone Grafting of Bone Cysts After Total Ankle Arthroplasty"],"prefix":"10.1177","volume":"37","author":[{"given":"Christopher E.","family":"Gross","sequence":"first","affiliation":[{"name":"Medical University of South Carolina, Charleston, SC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeannie","family":"Huh","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia","family":"Green","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Duke University, Durham, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samit","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Radiology, Musculoskeletal Radiology, Duke University Medical Center, Durham, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James K.","family":"DeOrio","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Easley","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"II","given":"James A.","family":"Nunley","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2015,10,1]]},"reference":[{"key":"bibr1-1071100715609055","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-199807000-00010"},{"key":"bibr2-1071100715609055","doi-asserted-by":"crossref","unstructured":"Besse JL, Brito N, Lienhart C. Clinical evaluation and radiographic assessment of bone lysis of the AES total ankle replacement. Foot Ankle Int. 2009;30(10):964-975. http:\/\/dx.doi.org\/10.3113\/FAI.2009.0964.","DOI":"10.3113\/FAI.2009.0964"},{"key":"bibr3-1071100715609055","doi-asserted-by":"crossref","unstructured":"Besse JL, Lienhart C, Fessy MH. Outcomes following cyst curettage and bone grafting for the management of periprosthetic cystic evolution after AES total ankle replacement. Clin Podiatr Med Surg. 2013;30:157-170. http:\/\/dx.doi.org\/10.1016\/j.cpm.2012.10.005.","DOI":"10.1016\/j.cpm.2012.10.005"},{"key":"bibr4-1071100715609055","doi-asserted-by":"crossref","unstructured":"Bonnin M, Gaudot F, Laurent JR, et al, The Salto total ankle arthroplasty: survivorship and analysis of failures at 7 to 11 years. Clin Orthop Relat Res. 2011;469:225-236. http:\/\/dx.doi.org\/10.1007\/s11999-010-1453-y.","DOI":"10.1007\/s11999-010-1453-y"},{"key":"bibr5-1071100715609055","doi-asserted-by":"publisher","DOI":"10.1097\/01.blo.0000132407.75881.a0"},{"key":"bibr6-1071100715609055","doi-asserted-by":"crossref","unstructured":"Brunner S, Barg A, Knupp M, et al, The Scandinavian total ankle replacement: long-term, eleven to fifteen-year, survivorship analysis of the prosthesis in seventy-two consecutive patients. J Bone Joint Surg Am. 2013;95:711-718. http:\/\/dx.doi.org\/10.2106\/JBJS.K.01580.","DOI":"10.2106\/JBJS.K.01580"},{"key":"bibr7-1071100715609055","doi-asserted-by":"crossref","unstructured":"Dalat F, Barnoud R, Fessy MH, Besse JL; French Association of Foot Surgery AFCP. Histologic study of periprosthetic osteolytic lesions after AES total ankle replacement. A 22 case series. Orthop Traumatol Surg Res. 2013;99(6 suppl):S285-S295. http:\/\/dx.doi.org\/10.1016\/j.otsr.2013.07.009.","DOI":"10.1016\/j.otsr.2013.07.009"},{"key":"bibr8-1071100715609055","doi-asserted-by":"crossref","unstructured":"Easley ME, Adams SBJr, Hembree WC, DeOrio JK. Results of total ankle arthroplasty. J Bone Joint Surg Am. 2011;93:1455-1468. http:\/\/dx.doi.org\/10.2106\/JBJS.J.00126.","DOI":"10.2106\/JBJS.J.00126"},{"key":"bibr9-1071100715609055","doi-asserted-by":"crossref","unstructured":"Glazebrook MA, Arsenault K, Dunbar M. Evidence-based classification of complications in total ankle arthroplasty. Foot Ankle Int. 2009;30(10):945-949. http:\/\/dx.doi.org\/10.3113\/FAI.2009.0945.","DOI":"10.3113\/FAI.2009.0945"},{"key":"bibr10-1071100715609055","doi-asserted-by":"crossref","unstructured":"Gougoulias N, Khanna A, Maffulli N. How successful are current ankle replacements? A systematic review of the literature. Clin Orthop Relat Res. 2010;468:199-208. http:\/\/dx.doi.org\/10.1007\/s11999-009-0987-3.","DOI":"10.1007\/s11999-009-0987-3"},{"key":"bibr11-1071100715609055","doi-asserted-by":"crossref","unstructured":"Haytmanek CTJr, Gross C, Easley ME, Nunley JA. Radiographic outcomes of a mobile-bearing total ankle replacement. Foot Ankle Int. 2015;36(9):1038-1044. http:\/\/dx.doi.org\/10.1177\/1071100715583353.","DOI":"10.1177\/1071100715583353"},{"key":"bibr12-1071100715609055","doi-asserted-by":"crossref","unstructured":"Henricson A, Skoog A, Carlsson A. The Swedish Ankle Arthroplasty Register: an analysis of 531 arthroplasties between 1993 and 2005. Acta Orthop. 2007;78:569-574. http:\/\/dx.doi.org\/10.1080\/17453670710014248.","DOI":"10.1080\/17453670710014248"},{"key":"bibr13-1071100715609055","doi-asserted-by":"crossref","unstructured":"Holt G, Murnaghan C, Reilly J, Meek RM. The biology of aseptic osteolysis. Clin Orthop Relat Res. 2007;460:240-252. http:\/\/dx.doi.org\/10.1097\/BLO.0b013e31804b4147.","DOI":"10.1097\/BLO.0b013e31804b4147"},{"key":"bibr14-1071100715609055","doi-asserted-by":"crossref","unstructured":"Kohonen I, Koivu H, Pudas T, Does computed tomography add information on radiographic analysis in detecting periprosthetic osteolysis after total ankle arthroplasty? Foot Ankle Int. 2013;34(2):180-188. http:\/\/dx.doi.org\/10.1177\/1071100712460224.","DOI":"10.1177\/1071100712460224"},{"key":"bibr15-1071100715609055","doi-asserted-by":"crossref","unstructured":"Koivu H, Kohonen I, Sipola E, Severe periprosthetic osteolytic lesions after the Ankle Evolutive System total ankle replacement. J Bone Joint Surg Br. 2009;91:907-914. http:\/\/dx.doi.org\/10.1302\/0301-620X.91B7.22434.","DOI":"10.1302\/0301-620X.91B7.22434"},{"key":"bibr16-1071100715609055","doi-asserted-by":"crossref","unstructured":"Kokkonen A, Ikavalko M, Tiihonen R, Kautiainen H, Belt EA. High rate of osteolytic lesions in medium-term followup after the AES total ankle replacement. Foot Ankle Int. 2011;32(2):168-175. http:\/\/dx.doi.org\/10.3113\/FAI.2011.0168.","DOI":"10.3113\/FAI.2011.0168"},{"key":"bibr17-1071100715609055","doi-asserted-by":"crossref","unstructured":"Rippstein PF, Huber M, Coetzee JC, Naal FD. Total ankle replacement with use of a new three-component implant. J Bone Joint Surg Am. 2011;93:1426-1435. http:\/\/dx.doi.org\/10.2106\/JBJS.J.00913.","DOI":"10.2106\/JBJS.J.00913"},{"key":"bibr18-1071100715609055","doi-asserted-by":"crossref","unstructured":"Saltzman CL, Mann RA, Ahrens JE, Prospective controlled trial of STAR total ankle replacement versus ankle fusion: initial results. Foot Ankle Int. 2009;30(7):579-596. http:\/\/dx.doi.org\/10.3113\/FAI.2009.0579.","DOI":"10.3113\/FAI.2009.0579"},{"key":"bibr19-1071100715609055","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2011.0755"},{"key":"bibr20-1071100715609055","doi-asserted-by":"crossref","unstructured":"Schutte BG, Louwerens JW. Short-term results of our first 49 Scandinavian total ankle replacements (STAR). Foot Ankle Int. 2008;29(2):124-127. http:\/\/dx.doi.org\/10.3113\/FAI.2008.0124.","DOI":"10.3113\/FAI.2008.0124"},{"key":"bibr21-1071100715609055","first-page":"S238","volume":"97","author":"Trincat S","year":"2011","journal-title":"Rev Chir Orthop Trauma"},{"key":"bibr22-1071100715609055","doi-asserted-by":"crossref","unstructured":"Yoon HS, Lee J, Choi WJ, Lee JW. Periprosthetic osteolysis after total ankle arthroplasty. 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