“… 40 All other incorporated studies in this review had Lysholm scores of 85 or higher at the final follow-up. 15 , 33 , 34 , 47 Thus, it is possible that patients in the included study by Chang et al had functionally lower scores preoperatively than those described by Kumar et al who received partial meniscectomy without formal decompression or removal of the cyst. 40 , 51 This consideration could potentially explain why the mean Lysholm scores for patients undergoing arthroscopic management of meniscal cysts were lower than those purely receiving a partial meniscectomy, although whether formal management of the meniscal cyst after partial meniscectomy is necessary or not remains a topic for future studies.…”
Section: Discussionmentioning
confidence: 94%
“…Some studies report marsupialization with creation of a permanent channel or further curettage of cyst wall to reduce the risk of recurrence Arthroscopic Excision 40 , 47 Arthroscopic partial meniscectomy with open cystectomy to remove the cyst cavity in its entirety. Arthroscopy Assisted Percutaneous Decompression 14 , 15 Decompression of cyst through the percutaneous passage of a large bore needle under arthroscopic visualization Figure 2 A visual representation of the distribution of morphologies of co-existing meniscal tears in patients with meniscal cysts. Horizontal tears were the most commonly seen morphology on arthroscopy, followed by Complex/“Parrot-Beak”, horizontal + radial, and radial tears.…”
Section: Resultsmentioning
confidence: 99%
“… 1 , 40 , 47 Only 2 studies provided insight on the rates of recurrence after arthroscopy assisted percutaneous decompression, which was calculated to be 0/37 (0%) ( Table 4 ). 14 , 15 …”
Section: Resultsmentioning
confidence: 99%
“…Patient perception of surgical outcomes after any type of arthroscopic surgery for meniscal cysts was reported by 5 studies, with an average calculated satisfaction rate (patients who self-reported being either very satisfied or satisfied) of 189/203 (93.1%) across these studies. 11 , 14 , 35 , 42 , 45 Extrapolation of satisfaction rate by specific procedure type was precluded in two studies where more than one surgical technique was utilized without adequate distinction of outcomes for each group. 11 , 42 Using data from the other 3 studies, satisfaction rates for arthroscopic decompression and arthroscopy assisted percutaneous drainage were noted to be 23/24 (95.8%) and 43/48 (89.6%), respectively.…”
Section: Resultsmentioning
confidence: 99%
“… 1 , 33 , 34 Percutaneous decompression using a low gauge needle is now often attempted with arthroscopic visualization, and comprises an additional method of surgical management for meniscal cysts. 14 , 35 …”
Purpose
The purpose of this study was to systematically review the outcomes of arthroscopic management of meniscal cysts and to compare the results across the reported surgical techniques.
Methods
Following the PRISMA methodology, 3 databases (PubMed, Scopus and Web of Science) were searched from inception to June 2021 for randomized controlled trials (RCTs) and observational studies reporting outcomes on patients with meniscal cysts who underwent arthroscopic surgery. The Mixed Methods Appraisal Tool (MMAT) was used to evaluate the study quality.
Results
Eighteen studies examining 753 patients (761 meniscal cysts; 92.5% in the lateral meniscus) were included. Overall, 486/736 (66.0%) patients underwent purely arthroscopic decompression, 174/736 (23.6%) received arthroscopic excision, 58/736 (7.9%) received arthroscopy assisted percutaneous drainage, and 18/736 (2.4%) received a combined procedure. The recurrence rate for meniscal cysts was 7.1% across all arthroscopic procedures; 8.3%, 3.4%, and 0% for arthroscopic decompression, arthroscopic excision, and arthroscopy assisted percutaneous drainage, respectively. A total of 79.3% of patients returned to the same level of sport and 85.7% had resolution or minimal knee symptoms after arthroscopic surgery for meniscal cysts. Patient perception of surgical outcomes after any type of arthroscopic surgery for meniscal cysts was reported by 5 studies, with 189/203 (93.1%) reporting satisfaction with their surgical procedure.
Conclusion
Based on current evidence, arthroscopic management of meniscal cysts yields satisfactory patient outcomes, low cyst recurrence rates and high return to sport rates regardless of the surgical technique. Rates of cyst recurrence were relatively higher with arthroscopic decompression versus excision and percutaneous drainage; however, prospective studies using modern surgical techniques are necessary to better evaluate the surgical outcomes and to compare those with nonoperative modalities, given that a significant proportion of the included articles in this review were relatively outdated.
Level of Evidence
Systematic review of level II and IV studies.
“… 40 All other incorporated studies in this review had Lysholm scores of 85 or higher at the final follow-up. 15 , 33 , 34 , 47 Thus, it is possible that patients in the included study by Chang et al had functionally lower scores preoperatively than those described by Kumar et al who received partial meniscectomy without formal decompression or removal of the cyst. 40 , 51 This consideration could potentially explain why the mean Lysholm scores for patients undergoing arthroscopic management of meniscal cysts were lower than those purely receiving a partial meniscectomy, although whether formal management of the meniscal cyst after partial meniscectomy is necessary or not remains a topic for future studies.…”
Section: Discussionmentioning
confidence: 94%
“…Some studies report marsupialization with creation of a permanent channel or further curettage of cyst wall to reduce the risk of recurrence Arthroscopic Excision 40 , 47 Arthroscopic partial meniscectomy with open cystectomy to remove the cyst cavity in its entirety. Arthroscopy Assisted Percutaneous Decompression 14 , 15 Decompression of cyst through the percutaneous passage of a large bore needle under arthroscopic visualization Figure 2 A visual representation of the distribution of morphologies of co-existing meniscal tears in patients with meniscal cysts. Horizontal tears were the most commonly seen morphology on arthroscopy, followed by Complex/“Parrot-Beak”, horizontal + radial, and radial tears.…”
Section: Resultsmentioning
confidence: 99%
“… 1 , 40 , 47 Only 2 studies provided insight on the rates of recurrence after arthroscopy assisted percutaneous decompression, which was calculated to be 0/37 (0%) ( Table 4 ). 14 , 15 …”
Section: Resultsmentioning
confidence: 99%
“…Patient perception of surgical outcomes after any type of arthroscopic surgery for meniscal cysts was reported by 5 studies, with an average calculated satisfaction rate (patients who self-reported being either very satisfied or satisfied) of 189/203 (93.1%) across these studies. 11 , 14 , 35 , 42 , 45 Extrapolation of satisfaction rate by specific procedure type was precluded in two studies where more than one surgical technique was utilized without adequate distinction of outcomes for each group. 11 , 42 Using data from the other 3 studies, satisfaction rates for arthroscopic decompression and arthroscopy assisted percutaneous drainage were noted to be 23/24 (95.8%) and 43/48 (89.6%), respectively.…”
Section: Resultsmentioning
confidence: 99%
“… 1 , 33 , 34 Percutaneous decompression using a low gauge needle is now often attempted with arthroscopic visualization, and comprises an additional method of surgical management for meniscal cysts. 14 , 35 …”
Purpose
The purpose of this study was to systematically review the outcomes of arthroscopic management of meniscal cysts and to compare the results across the reported surgical techniques.
Methods
Following the PRISMA methodology, 3 databases (PubMed, Scopus and Web of Science) were searched from inception to June 2021 for randomized controlled trials (RCTs) and observational studies reporting outcomes on patients with meniscal cysts who underwent arthroscopic surgery. The Mixed Methods Appraisal Tool (MMAT) was used to evaluate the study quality.
Results
Eighteen studies examining 753 patients (761 meniscal cysts; 92.5% in the lateral meniscus) were included. Overall, 486/736 (66.0%) patients underwent purely arthroscopic decompression, 174/736 (23.6%) received arthroscopic excision, 58/736 (7.9%) received arthroscopy assisted percutaneous drainage, and 18/736 (2.4%) received a combined procedure. The recurrence rate for meniscal cysts was 7.1% across all arthroscopic procedures; 8.3%, 3.4%, and 0% for arthroscopic decompression, arthroscopic excision, and arthroscopy assisted percutaneous drainage, respectively. A total of 79.3% of patients returned to the same level of sport and 85.7% had resolution or minimal knee symptoms after arthroscopic surgery for meniscal cysts. Patient perception of surgical outcomes after any type of arthroscopic surgery for meniscal cysts was reported by 5 studies, with 189/203 (93.1%) reporting satisfaction with their surgical procedure.
Conclusion
Based on current evidence, arthroscopic management of meniscal cysts yields satisfactory patient outcomes, low cyst recurrence rates and high return to sport rates regardless of the surgical technique. Rates of cyst recurrence were relatively higher with arthroscopic decompression versus excision and percutaneous drainage; however, prospective studies using modern surgical techniques are necessary to better evaluate the surgical outcomes and to compare those with nonoperative modalities, given that a significant proportion of the included articles in this review were relatively outdated.
Level of Evidence
Systematic review of level II and IV studies.
PurposePost‐operative meniscal cyst formation occurs following all‐inside device meniscal repair. This study aimed to compare the incidence of cysts in patients who underwent meniscal repair with and without all‐inside suture devices.MethodsThis retrospective study included 227 knees that underwent meniscal repair between 2021 and 2022. The incidence of post‐operative meniscal cysts was compared between patients who underwent repair using an all‐inside suture anchor device (Group SA) and those who did not use an anchor (Group NA), based on post‐operative magnetic resonance imaging (MRI) findings. Risk factors, such as the number of anchors used, were investigated. Using a subgroup analysis, the incidence of meniscal cysts based on the type of device used was investigated.ResultsGroups SA and NA comprised 125 and 102 knees, respectively. Group SA had 11 cases of cysts (9% incidence), whereas Group NA had 7 cases (7% incidence), and no statistically significant difference was observed (p = 0.63). Symptomatic cysts were observed in two patients (1.6%) in Group SA, whereas none was observed in Group NA (0%); the difference was not significant (p = 0.50). Factors such as the number of anchors and sutures used and MRI timing were not identified as risk factors. Cyst incidence varied according to anchor type: Stryker AIR+ (4 out of 55, 7%), Smith & Nephew Fast‐Fix 360 (7 out of 56, 13%) and Arthrex Fiber Stitch (0 out of 26, 0%), with no significant difference found (p = 0.14).ConclusionThe incidence of cysts in patients undergoing meniscal repair with an all‐inside suture anchor device was 9%, showing no significant difference compared with Group NA. Cyst incidence was not affected by device type.Level of EvidenceLevel III, retrospective comparative study.
PurposeAn arthroscopic partial meniscectomy (APM) for degenerative meniscus lesions and traumatic meniscus tears are two distinct entities and their long‐term outcomes are rarely reported. The aim of this review was to compare the long‐term (clinical and radiological) results of APM performed on stable knees for traumatic tears (TT) or degenerative lesions (DL).MethodsPubmed, Scopus and Embase databases were searched to identify relevant studies published between 2010 and 2023 using the keywords ‘meniscectomy’ OR ‘meniscectomies’ OR ‘meniscal resection’. English‐language, Levels I–IV evidence studies reporting either radiographic or clinical outcome measures with a minimum of 6 years' follow‐up after APM were included. Studies including discoid meniscus, open meniscectomy, unstable knee and combination with other procedures were excluded. To rate the quality of evidence, the methodological index for non‐randomized studies was used.ResultsThirty‐two studies were included, with follow‐up periods ranging from 6 to 22 years. Eleven studies dealt with TT with a mean age of 31.5 ± 6.6 years and a mean follow‐up of 11.6 ± 6.9 years. At the last follow‐up, radiographic osteoarthritis (OA) ranged from 36% to 76%, with an average rate of 48 ± 19%; functional scores ranged from 71 to 97, with a mean of 90 ± 4 for the Lysholm score, 86 ± 10 for the International Knee Documentation Committee (IKDC) and 94 ± 16 for the knee injury and osteoarthritis outcome (KOOS). Twenty‐one studies dealt with DL with a mean age of 49.9 ± 7.2 years and a mean follow‐up of 14.9 ± 6.3 years. At the last follow‐up, radiographic OA ranged from 23% to 97%, with an average rate of 77 ± 28%; functional scores ranged from 40 to 87, with a mean of 79 ± 10 for the Lysholm score and 71 ± 16 for the IKDC.ConclusionTen‐year clinical outcomes of APM are better for TTs when compared to DLs. Rates of OA are difficult to compare but lower for TTs.Level of EvidenceLevel IV.
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