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Navicular bone cyst with osteochondral defect. How is bone marrow harvested in the surgery? What is the recovery period?

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I had foot surgery 1 month ago. My pre-op diagnosis was navicular bone cyst with osteochondral defect. I asked if this could mean osteochondritis dissecans and my doctor said yes. I'm 38 years old. There's been no obvious cause. Postoperatively, my surgeon told my spouse he drilled into the top of the navicular bone, evacuated the cyst, and filled the defect with bone marrow. 1. Where is bone marrow typically harvested from for this procedure? 2. How much time will it take for my condition to completely heal? (months/years?). I'm currently in a walking cast (planned for 5 weeks total) and this was preceded by 2 weeks of complete non-weightbearing.
Posted Sat, 7 Jul 2012 in Bones, Muscles and Joints
 
 
Answered by Dr. Atul Wankhede 1 hour later
Dear user,
Thanks for choosing XXXXXXX for your health related query.

What your orthopaedician did was very appropriate. To evacuate the cyst and to fill up with marrow or bone grafts (autologous/artificial) is the standard protocol.

1. Bone marrow is generally harvested from long bones, whose canal is XXXXXXX in marrow cells. Long bones like Tibia or Femur are usually chosen. (For bone grafts if atall taken are harvested from Iliac crest).

2. Time required for healing varies in all individuals, on an average 6 to 8 weeks for radiological evidence of healing.

I hope this answers your questions. If you need more assistance, I'm available for follow up.
Regards.
Above answer was peer-reviewed by
 
Follow-up: Navicular bone cyst with osteochondral defect. How is bone marrow harvested in the surgery? What is the recovery period? 10 hours later
Thanks for your response.

My surgeon said my case is rare. I'm not certain if it's rare because it involves the foot navicular bone or because it involves osteochondritis dissecans. Can you please help me understand for what reason my case is rare? Are there any absolute activity contraindications for me when this heals?
 
 
Answered by Dr. Atul Wankhede 19 hours later
Hello once again.
Thanks for replying back.

Indeed its a rare condition and Navicular bone involvement is even rarer in osteochondritis dissecans. There is no particular reason for its rarity, or rather there is little evidence of the factors that cause this condition. And above all, there are many conditions that resemble the condition so the diagnosis usually is delayed or misdiagnosed.

There is no absolute activity contraindication, but lifestyle modification and prevention of exertion, protected weight bearing and many other cautions to prevent subsequent fractures.

Nevertheless, allow some time for it to heal. You have good chances of it to heal completely at your age. Wish you all the luck.
Regards.
Above answer was peer-reviewed by
 
Follow-up: Navicular bone cyst with osteochondral defect. How is bone marrow harvested in the surgery? What is the recovery period? 3 hours later
Thanks for your response.

Prior to surgery 1 month ago, I had localized navicular bone pain that worsened with weather-pressure changes. Postoperatively, I thought that would go away but in the last few days, our weather has become very hot with a lot of humidity and some rainstorms. My foot was killing me last night and the last 2 afternoons. Pain comes more diffusely but is still intense. My fear is that I have some component of arthritis...but I'm wondering if such pain will resolve or lessen significantly in time when I complete the healing phase from surgery. Any insights?
 
 
Answered by Dr. Atul Wankhede 1 hour later
Dear user.
Glad to see your reply.

You most definitely will have relief as soon as the healing is complete. That's the first symptomatic sign of recovery. Your fear of early arthritic change is not completely wrong. There is a good possibility of that ensuing soon. The pain you had prior to surgery must be due to the dying bone tissue with lack of blood. Have patience, the pain will go eventually.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Navicular bone cyst with osteochondral defect. How is bone marrow harvested in the surgery? What is the recovery period? 34 hours later
Thank you for answering my questions. You've been very helpful. I guess I have one last question..."if" I don't heal properly and should require a fusion of foot bones, would I experience a "dramatic" loss of foot mobility (given that the fusion would involve the upper foot/navicular area)?
 
 
Answered by Dr. Atul Wankhede 5 hours later
Dear user,
Thanks for replying back.

There will be loss of mobility in its entirity once fusion is done. But its a age old well known procedure that gives acceptable amount of movement of leg. It won't hamper your gait.

Regards.
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