Endoscopically and Fluoroscopically Assisted Curettage and Bone Grafting of the Navicular Bone Cyst  Tun Hing Lui, M.B.B.S.(HK), F.R.C.S.(Edin), F.H.K.A.M., F.H.K.C.O.S.  Arthroscopy Techniques  Volume 5, Issue 6, Pages e1221-e1227 (December 2016) DOI: 10.1016/j.eats.2016.07.016 Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 1 Endoscopically and fluoroscopically assisted curettage and bone grafting of the right navicular bone cyst. Preoperative magnetic resonance imaging ([A] axial view; [B] sagittal view) and computed tomogram ([C] coronal view; [D] sagittal view) of the illustrated case confirm the diagnosis and study the location, dimension, and architecture of the navicular bone cyst (arrowhead). Arthroscopy Techniques 2016 5, e1221-e1227DOI: (10.1016/j.eats.2016.07.016) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 2 Endoscopically and fluoroscopically assisted curettage and bone grafting of the right navicular bone cyst. The dorsolateral midtarsal portal (DLMP) is located at the junction between the talonavicular and calcaneocuboid joints. The lateral midtarsal portal (LMP) is located at the plantar lateral corner of the calcaneocuboid joint. Arthroscopy Techniques 2016 5, e1221-e1227DOI: (10.1016/j.eats.2016.07.016) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 3 Endoscopically and fluoroscopically assisted curettage and bone grafting of the right navicular bone cyst. The lateral midtarsal portal is the viewing portal. The soft tissue over the lateral wall of the navicular bone (N) is stripped by an arthroscopic shaver via the dorsolateral midtarsal portal. (T, talar head.) Arthroscopy Techniques 2016 5, e1221-e1227DOI: (10.1016/j.eats.2016.07.016) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 4 Endoscopically and fluoroscopically assisted curettage and bone grafting of the right navicular bone cyst. The lateral midtarsal portal (LMP) is the viewing portal. (A) The bone tunnel is made from the lateral navicular wall to the bone cyst. A bone tunnel is created by drilling the lateral cortex of the navicular bone toward the bone cyst. (B) Arthroscopic view of the bone tunnel (BT) of the lateral navicular (N) wall. (DLMP, dorsolateral midtarsal portal; T, talar head.) Arthroscopy Techniques 2016 5, e1221-e1227DOI: (10.1016/j.eats.2016.07.016) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 5 Endoscopically and fluoroscopically assisted curettage and bone grafting of the right navicular bone cyst. (A) The arthroscope is inserted into the bone tunnel via the dorsolateral midtarsal portal (DLMP). (B) The bone cyst (BC) and its fibrous membrane (FM) are assessed arthroscopically. (BT, bone tunnel.) Arthroscopy Techniques 2016 5, e1221-e1227DOI: (10.1016/j.eats.2016.07.016) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 6 Endoscopically and fluoroscopically assisted curettage and bone grafting of the right navicular bone cyst. (A) An arthroscopic curette (Acufex; Smith & Nephew) is inserted into the cyst via the dorsolateral midtarsal portal (DLMP). The cyst wall is curetted under fluoroscopic guide ([B] dorsoplantar view; [C] lateral view). Arthroscopy Techniques 2016 5, e1221-e1227DOI: (10.1016/j.eats.2016.07.016) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 7 Endoscopically and fluoroscopically assisted curettage and bone grafting of the right navicular bone cyst. (A) The dorsolateral midtarsal portal is the viewing portal. The fibrous membrane loosened by the curette can be seen. (B) The scope is replaced by the arthroscopic shaver and the loosened fibrous membrane is resected by the shaver. (BT, bone tunnel; DLMP, dorsolateral midtarsal portal; LFM, loosened fibrous membrane.) Arthroscopy Techniques 2016 5, e1221-e1227DOI: (10.1016/j.eats.2016.07.016) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 8 Endoscopically and fluoroscopically assisted curettage and bone grafting of the right navicular bone cyst. The dorsolateral midtarsal portal is the viewing portal. The bone cyst (BC) is completely debrided. (BT, bone tunnel.) Arthroscopy Techniques 2016 5, e1221-e1227DOI: (10.1016/j.eats.2016.07.016) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 9 Endoscopically and fluoroscopically assisted curettage and bone grafting of the right navicular bone cyst. The lateral midtarsal portal is the viewing portal. The drill guard (DG) loaded with cancellous bone graft is inserted via the dorsolateral midtarsal portal and placed to the orifice of the bone tunnel (BT). Arthroscopy Techniques 2016 5, e1221-e1227DOI: (10.1016/j.eats.2016.07.016) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions