Intra-Articular Ganglion Cysts of the Knee

Abstract

Magnetic resonance imaging (MRI) without contrast is sufficient to diagnose an intra-articular ganglion cyst of the knee. MRI with intravenous contrast may be considered for cysts in the infrapatellar fat pad, which are not a typical presentation.The current literature supports treating symptomatic cases or those discovered accidently during knee arthroscopy with arthroscopic excision.Although aspiration of these cysts results in a higher recurrence rate than excision, it is associated with quicker recovery. Thus, aspiration might be chosen as an initial treatment for anyone who would like to avoid surgery or requires a rapid recovery, including professional athletes.Open excision may be considered for infrapatellar fat pad cysts that are >4.5 cm in size.

Atraumatic intra‐articular, extra‐synovial ganglion cyst of the lateral knee deep to the iliotibial band: A case report and review of the literature

“…14 The proposed management for intra-articular GC of the knee include arthroscopic excision, open excision, and nonoperative therapy including joint aspirations. 15 According to current literature, arthroscopic excision is the most commonly used operative procedure for intraarticular GC. The advantages include a low recurrence rate and the ability to take a biopsy specimen during arthroscopy and address any concomitant articular damage within the knee joint.…”

“…The advantages include a low recurrence rate and the ability to take a biopsy specimen during arthroscopy and address any concomitant articular damage within the knee joint. 15 Krudwig et al analyzed 85 intraarticular GC found during 8000 procedures managed subsequently with arthroscopic excision and noted acceptable clinical outcomes with no recurrence. 3 Additionally, Brown and Dandy identified 38 cases of intra-articular GC of the knee out of 6500 knee arthroscopies also subsequently treated with arthroscopic excision and reported good to excellent clinical outcomes in 95% of these patients.…”

“…16 Open excision is used for large, extra-articular GC of the knee and may be indicated in infrapatellar fat pad GC >4.5 cm in size. 12,15 In regard to nonoperative therapy, several studies have suggested no treatment for asymptomatic cysts found incidentally during MRI and have even noted shrinkage of symptomatic cysts with nonoperative therapy, although it is recommended to clinically monitor cysts in the event of future enlargement or compressive effects that may require surgery. 3,17,18 In contrast to most reported literature on intraarticular GC of the knee, we report the case of a patient who was successfully treated with repeat joint aspirations of the knee, rather than through arthroscopic excision.…”

“…The proposed management for intra‐articular GC of the knee include arthroscopic excision, open excision, and nonoperative therapy including joint aspirations 15 . According to current literature, arthroscopic excision is the most commonly used operative procedure for intra‐articular GC.…”

“…According to current literature, arthroscopic excision is the most commonly used operative procedure for intra‐articular GC. The advantages include a low recurrence rate and the ability to take a biopsy specimen during arthroscopy and address any concomitant articular damage within the knee joint 15 . Krudwig et al.…”