28102 Excision or curettage of bone cyst or benign tumor, talus or calcaneus; with iliac or other autograft (includes obtaining graft)

Name of the Procedure:

Excision or Curettage of Bone Cyst or Benign Tumor, Talus or Calcaneus with Iliac or Other Autograft

Summary

This surgical procedure involves the removal of a bone cyst or benign tumor from the talus or calcaneus (bones in the ankle and heel), followed by filling the bone defect with an autograft (bone graft taken from the patient's own body, often from the iliac crest of the pelvis).

Purpose

The purpose of this procedure is to treat benign bone tumors or cysts in the talus or calcaneus, which can cause pain, swelling, or structural weakness and may interfere with normal ankle and foot function. The goal is to remove the growth, alleviate symptoms, and restore structural integrity to the affected bone.

Indications

• Persistent pain or swelling in the ankle or heel.
• Presence of a benign bone cyst or tumor confirmed by imaging studies.
• Structural weakness or risk of fracture in the talus or calcaneus due to the bone cyst or tumor.
• Failure of non-surgical treatments to relieve symptoms.

Preparation

• Pre-procedure fasting (usually 8 hours prior).
• Stopping certain medications as advised by the doctor (e.g., blood thinners).
• Diagnostic imaging (X-ray, MRI, or CT scan) to evaluate the cyst or tumor.
• Blood tests and pre-anesthetic assessment.

Procedure Description

1. Anesthesia: General or regional anesthesia is administered.
2. Incision: A surgical incision is made over the affected area.
3. Excision/Curettage: The bone cyst or tumor is carefully excised or curetted (scraped out).
4. Autograft Harvesting: Bone graft is obtained from the iliac crest or another donor site on the patient's body.
5. Grafting: The bone defect is filled with the harvested autograft.
6. Closure: The incision is closed with sutures, and a sterile dressing is applied.

Duration

The procedure typically takes about 1 to 2 hours, depending on the complexity.

Setting

The procedure is usually performed in a hospital or a surgical center equipped with appropriate facilities.

Personnel

• Orthopedic or podiatric surgeon
• Surgical nurse
• Anesthesiologist
• Surgical technician

Risks and Complications

• Infection at the surgical site.
• Bleeding or hematoma formation.
• Nerve or blood vessel damage.
• Graft rejection or complications at the donor site.
• Risks associated with anesthesia.
• Possible recurrence of the cyst or tumor.

Benefits

• Alleviation of pain and swelling.
• Restoration of bone strength and function.
• Prevention of fractures or further complications.
• Improved joint mobility.

Recovery

• Hospital stay of 1-2 days post-surgery.
• Pain management with prescribed medications.
• Keeping weight off the affected foot for several weeks.
• Use of crutches or a walker as advised.
• Follow-up appointments for wound care and monitoring.
• Physical therapy may be recommended to regain strength and mobility.
• Full recovery typically takes several weeks to months.

Alternatives

• Observation and monitoring for small, asymptomatic cysts or tumors.
• Non-surgical treatments such as medications, injections, or physical therapy.
• Comparison: While non-surgical options have fewer immediate risks, they may not provide definitive relief or prevent complications as effectively as surgery.

Patient Experience

• During the procedure: Under anesthesia, so no pain felt.
• After the procedure: Initial pain and discomfort at both the surgical and donor sites, managed with pain medication.
• Gradual improvement in symptoms over weeks to months.
• Physical therapy to aid recovery and restore function.