Balbouzis T, Alexopoulos T, Grigoris P. Os calcis lipoma: To graft or not to graft? - A case report and literature review. World J Orthop 2019; 10(7): 292-298 [PMID: 31360644 DOI: 10.5312/wjo.v10.i7.292]
Corresponding Author of This Article
Theodoros Balbouzis, MD, MA, Orthopaedic Surgeon, Department of Orthopaedics, Metropolitan General Hospital, Mesogeion 264, Holargos, Athens 15562, Greece. drbalbouzis@yahoo.com
Research Domain of This Article
Orthopedics
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. Jul 18, 2019; 10(7): 292-298 Published online Jul 18, 2019. doi: 10.5312/wjo.v10.i7.292
Os calcis lipoma: To graft or not to graft? - A case report and literature review
Theodoros Balbouzis, Theodosios Alexopoulos, Peter Grigoris
Theodoros Balbouzis, Peter Grigoris, Department of Orthopaedics, Metropolitan General Hospital, Holargos, Athens 15562, Greece
Theodosios Alexopoulos, Department of Radiology, Metropolitan General Hospital, Holargos, Athens 15562, Greece
Author contributions: Balbouzis T, Alexopoulos T and Grigoris P have substantially contributed in this article; all authors issued final approval for the version to be submitted.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Theodoros Balbouzis, MD, MA, Orthopaedic Surgeon, Department of Orthopaedics, Metropolitan General Hospital, Mesogeion 264, Holargos, Athens 15562, Greece. drbalbouzis@yahoo.com
Telephone: +30-210-7290959
Received: March 6, 2019 Peer-review started: March 8, 2019 First decision: June 12, 2019 Revised: June 25, 2019 Accepted: July 8, 2019 Article in press: July 8, 2019 Published online: July 18, 2019 Processing time: 135 Days and 10.6 Hours
Abstract
BACKGROUND
Intraosseous lipoma is a rare benign lesion, commonly affecting the os calcis. Its pathogenesis and natural history are not fully understood, and its management remains controversial.
CASE SUMMARY
A 56-year-old male complaining of heel pain was diagnosed with an os calcis lipoma. The lesion was treated with curettage and it was filled with impacted allograft and demineralized bone matrix. Histological examination confirmed the above diagnosis. Six months postoperatively, the patient returned to recreational long-distance running. Repeated computed tomography scanning, up to five years postoperatively, showed almost complete resorption of the graft over time.
CONCLUSION
The treatment of an os calcis lipoma should be individualized, depending on the symptoms, the location and size of the lesion. Surgeons, electing to proceed with bone grafting, should consider the probability of bone graft resorption.
Core tip: This is the first report of a patient with a surgically treated os calcis lipoma, showing spectacular graft resorption at a long-term follow up. Previous studies, which report satisfactory graft performance, rely on plain radiographs for follow-up imaging and they have not used computed tomography to assess the incorporation of bone graft. The complex interplay of biomechanical and biological factors in Ward’s neutral triangle of the os calcis may account for the failure of graft integration. The possibility of bone graft resorption must be taken into account when surgical treatment is considered.
