Description of patient (type of occupation, indication of age, intensity of sport):
45 year old active female.
History and previous treatment:
Deep medial ankle pain with activity. Mild previous trauma and no previous surgery.
Pain in the medial ankle.
Full range of motion- medial malleolus pain and pain over the medial ankle joint. No effusion.
Additional investigation (CT/MRI):
MRI- attached- large medial cyst communicating with the joint- medial distal tibia.
45 year old female with large tibial OCL and pain with activity. Surgical management?
Question(s) to this case:
How to approach this surgically? Graft from inside, or open cortical window from outside?
Cortical window with curetting the cyst and destruction of the cyst wall into bleeding bone followed by a massive autologous bone graft should best be done. Try to identify the opening from the joint to the cyst and curette the entrance.