A clinical examination revealed tenderness along the anteromedial joint line. She did not have a relevant past medical history nor did she use any long-term medications. The patient worked as a nurse and reported dull pain throughout the day that worsened by the end of her shift, thereby restricting her from functioning efficiently in her demanding job. We reviewed a 46-year-old female patient in the clinic who experienced atraumatic right ankle pain over the past 3 years. those larger than 150 mm 2) of the talus with calcium phosphate injection leading to good clinical patient outcomes. Here, we present a novel arthroscopic technique for managing large subchondral cysts (i.e. Conventional open surgical techniques carry approach-related morbidity, and arthroscopic techniques are restricted to repairing small lesions (i.e. Surgical treatment of these lesions depends on the lesion’s stage, location and size. They are devoid of soft tissue attachment and lack sufficient blood supply, leading to poor healing and complications such as osteonecrosis. These lesions are challenging to treat because of a large articular surface area, comprising 60% of the total talar body surface area. Subchondral talar cysts are osteochondral defects in the talus and are a source of chronic ankle pain. Both tolerated the surgery well, with significant reductions noted in MOXFQ scores at the 1-year follow-up. This case series presents two patients who underwent subchondroplasty: a 44-year-old female nurse with atraumatic right ankle pain of 2 years with a CT scan revealing a large subchondral cyst over the medial talar dome and a 55-year-old male chemical plant worker with left ankle pain following a biking accident 6 years ago whose CT scan too showed a large subchondral cyst in the medial talus. Subchondroplasty involves arthroscopically approaching the cyst and injecting it with calcium phosphate paste injection, which undergoes an endothermic process and crystallizes in a manner that resembles cancellous bone to fill the defect. It avoids soft tissue scarring, the need for osteotomies, bone grafting and its associated complications as seen with conventional approaches. Subchondroplasty is a novel and minimally invasive technique used to treat large subchondral talar cysts.
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