Clinical outcome of arthroscopic management of popliteal cysts with or without additional posterior open cystectomy

Xu, Xinxian; Y, Hu; Jiang, Lin; Yu, Huachen

doi:10.1007/s00132-018-3573-0

Cited by 10 publications

(6 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…With the improvement of the mean Lysholm score from 54 to 86 at a mean follow-up of 39 months reported in this study, the results are comparable with the abovementioned literature, with longer follow-up. On contrary, in the study of Xinxian et al, the authors reported improvement of the Lysholm score in arthroscopically treated group from the preoperative mean of 76.6 to 86.3 at the mean of 33.3 months follow-up [ 20 ]. While authors stated that all patients “complained of symptomatic knee joint pain and/or joint limitation,” a lot higher preoperative Lysholm score than in the rest of the literature can be seen, making direct comparison of outcomes difficult [ 7 , 19 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic cystectomy and valve excision of popliteal cysts complemented with management of intra-articular pathologies: a low recurrence rate and good functional outcomes in a series of ninety seven cases

Malinowski

Mostowy

Ebisz³

et al. 2023

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

Purpose Arthroscopy in popliteal cyst surgery enables addressing all components of its pathomechanism: the cyst wall, valvular mechanism, and concomitant intra-articular pathologies. Techniques differ as to the management of the cyst wall and the valvular mechanism. This study aimed to assess the recurrence rate and functional outcomes of a cyst wall and valve excising arthroscopic technique with concurrent intra-articular pathology management. The secondary purpose was to assess cyst and valve morphology and concomitant intra-articular findings. Methods Between 2006 and 2012, 118 patients with symptomatic popliteal cysts refractory to at least three months of guided physiotherapy were operated on by a single surgeon using a cyst wall and valve excising arthroscopic technique with intra-articular pathology management. Patients were evaluated preoperatively and at a mean follow-up of 39 months (range 12–71) by ultrasound, Rauschning and Lindgren, Lysholm, and VAS of perceived satisfaction scales. Results Ninety-seven out of 118 cases were available for follow-up. Recurrence was observed on ultrasound in 12/97 cases (12.4%); however, it was symptomatic only in 2/97 cases (2.1%). Mean scores improved: Rauschning and Lindgren from 2.2 to 0.4, Lysholm from 54 to 86, and VAS of perceived satisfaction from 5.0 to 9.0. No persistent complications occurred. Arthroscopy revealed simple cyst morphology in 72/97 (74.2%) and presence of a valvular mechanism in all cases. The most prevalent intra-articular pathologies were medial meniscus (48.5%) and chondral lesions (33.0%). There were significantly more recurrences in grade III–IV chondral lesions (p = 0.03). Conclusions Arthroscopic popliteal cyst treatment had a low recurrence rate and good functional outcomes. Severe chondral lesions increase the risk of cyst recurrence.

show abstract

Section: Discussionmentioning

confidence: 99%

Arthroscopic cystectomy and valve excision of popliteal cysts complemented with management of intra-articular pathologies: a low recurrence rate and good functional outcomes in a series of ninety seven cases

Malinowski

Mostowy

Ebisz³

et al. 2023

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

show abstract

“…Likewise, a retrospective study by Xinxian et al including 65 patients with symptomatic popliteal cysts over eight years compared the arthroscopic management of intra-articular pathologies and decompression of the cyst with and without open cyst wall resection, revealing better clinical outcomes and lower recurrence rates when the latter is included, but with a longer surgical time and postoperative complications at a mean 33.3 months follow-up [15]. Although there was no recurrence during the one-year follow-up of the present case report, it represents the most common complication reported as high as in 63% of the cases [9,16].…”

Section: Discussionmentioning

confidence: 99%

“…A systematic review by Zhou et al pooled data from 11 studies, comparing different surgical methods in therapy of popliteal cyst, showing that following these principles yielded satisfactory outcomes in more than 95% of the patients, but data was insufficient to support arthroscopic over open approach [ 5 ]. Likewise, a retrospective study by Xinxian et al including 65 patients with symptomatic popliteal cysts over eight years compared the arthroscopic management of intra-articular pathologies and decompression of the cyst with and without open cyst wall resection, revealing better clinical outcomes and lower recurrence rates when the latter is included, but with a longer surgical time and postoperative complications at a mean 33.3 months follow-up [ 15 ]. Although there was no recurrence during the one-year follow-up of the present case report, it represents the most common complication reported as high as in 63% of the cases [ 9 , 16 ].…”

Section: Discussionunclassified

Tibial Nerve Palsy: An Atypical Presentation of a Popliteal Cyst

Stéfanou¹,

Kalifis²,

Fermín³

et al. 2022

Cureus

View full text Add to dashboard Cite

Popliteal cysts represent one of the commonest knee pathologies in the adult population. The vast majority of cases may be treated conservatively as symptoms tend to resolve spontaneously. However, few patients may experience persistent pain and nerve-related symptoms not responding to conservative management. We present a case of a 46-year-old patient who suffered from tibial nerve palsy due to a popliteal cyst that was treated successfully with combined open and arthroscopic procedure. It is important to understand that popliteal cysts rarely may lead to tibial nerve entrapment and in selected cases operative management may be indicated.

show abstract

“…Posterior open surgery has traditionally been used for symptomatic popliteal cysts with ineffective conservation 6,9 . This type of operation not only carries risk of nerve damage, but also requires longer operation times and is more prone to perioperative complications [16][17][18] . In addition, this method only focuses on the cyst itself, and does not consider the intra-articular pathology and unidirectional valve mechanism, so the cyst may easily recur.…”

Section: Introductionmentioning

confidence: 99%

Arthroscopic Internal Drainage with Cyst Wall Resection and Arthroscopic Internal Drainage with Cyst Wall Preservation to Treat Unicameral Popliteal Cysts: A Retrospective Case–Control Study

Zhang

Wang

et al. 2021

Orthopaedic Surgery

View full text Add to dashboard Cite

Objective: To compare the clinical efficacy and safety of arthroscopic internal drainage for the treatment of unicameral popliteal cysts with or without cyst wall resection.Methods: This was a retrospective case-control study of 73 patients diagnosed with unicameral popliteal cysts from January 2012 to January 2019 who received arthroscopic treatment. The study included 38 cases with cyst wall resection (CWR group) and 35 cases with cyst wall preservation (CWP group). The CWR group consisted of 14 men and 24 women with an average age of 51.8 years, while the CWP group consisted of 13 men and 22 women with an average age of 52.0 years. All patients were examined for intra-articular lesions and communicating ports by magnetic resonance imaging (MRI) prior to surgery, and recurrence of cysts was evaluated at the last follow-up examination. Rauschning and Lindgren grade (R-L grade) and Lysholm score were used to evaluate clinical outcomes. In addition, operation time and complications were recorded. Results:The average length of follow-up was 24.2 months (range, 16 to 32 months). There were no considerable differences in age, gender, cyst size, Lysholm score, R-L grade and concomitant intra-articular cases between the CWR group and CWP group prior to surgery (P > 0.05). The last follow-up MRI scans showed that in the CWR group, the cyst disappeared in 25 cases and shrunk in 13 cases. In the CWP group, the cyst disappeared in 22 cases, shrunk in 12 cases and persisted in one case. There was no obvious difference in recurrence rate between the two groups (0% vs 2.9%, P = 0.899). At the last follow-up, there were no differences in the R-L grade (P = 0.630) and Lysholm score (88.3 AE 5.6 points vs 90.1 AE 3.8 points, P = 0.071) between the two groups. Compared with the CWP group, operation time was significantly prolonged in the CWR group (38.3 AE 3.1 min vs 58.3 AE 4.4 min, P < 0.05). In the CWR group, three cases occurred fluid infiltration under the gastrocnemius muscle, which improved after pressure bandaging and cold compress. In another three cases, hematoma was found. The incidence of complications in the CWR group was markedly higher than that in the CWP group (15.8% vs 0%, P < 0.05). During the follow-up period, none of the patients developed serious complications such as neurovascular injury, deep venous thrombosis, or infection. Conclusion:For unicameral popliteal cysts, arthroscopic internal drainage combined with resection of the cyst wall did not further improve the clinical outcomes or reduce the recurrence rate, while prolonging the operation time and increasing the possibility of complications.

show abstract

Clinical outcome of arthroscopic management of popliteal cysts with or without additional posterior open cystectomy

Abstract: In comparison to arthroscopic decompression of cysts and management of intra-articular pathologies alone, the additional posterior open cystectomy reduced the recurrence of popliteal cysts, although it took longer to perform and brought more perioperative complications.

Cited by 10 publications

References 15 publications

Arthroscopic cystectomy and valve excision of popliteal cysts complemented with management of intra-articular pathologies: a low recurrence rate and good functional outcomes in a series of ninety seven cases

Arthroscopic cystectomy and valve excision of popliteal cysts complemented with management of intra-articular pathologies: a low recurrence rate and good functional outcomes in a series of ninety seven cases

Tibial Nerve Palsy: An Atypical Presentation of a Popliteal Cyst

Arthroscopic Internal Drainage with Cyst Wall Resection and Arthroscopic Internal Drainage with Cyst Wall Preservation to Treat Unicameral Popliteal Cysts: A Retrospective Case–Control Study

Contact Info

Product

Resources

About