Endoscopic curettage and bone grafting of huge talar bone cyst with preservation of cartilaginous surfaces: Surgical planning

• Massive talar bone cyst may not be associated with a large sized osteochondral lesion.
• If the osteochondral lesion is small, adequate exposure of the cyst through the articular surface would mean unnecessary removal of areas of normal cartilage.
• Detailed surgical planning can allow endoscopic curettage and bone grafting of the cyst with preservation of the articular surfaces.
• Pre-operative computed tomogram is necessary for preoperative planning.

Open curettage and bone grafting of the huge talar cysts may need extensive soft tissue dissection or even different types of malleolar osteotomy to access the lesion. Arthroscopic approach can minimize soft tissue dissection or the need for malleolar osteotomy. Careful pre-operative planning of the portal sites allows endoscopic curettage and bone grafting of the lesions with preservation of the articular surfaces.