Abstract:Popliteal cysts can be an oppressive symptom in patients with concomitant intra-articular knee pathologies. Because isolated treatment of intra-articular lesions is usually not sufficient to resolve the problems associated with a large symptomatic popliteal cyst, a popliteal cyst should be concurrently addressed with other knee pathologies to maximize patient outcomes. Conservative treatment and open surgical excision are associated with high rates of recurrence, so arthroscopic techniques are the preferred tr… Show more
“…We can choose portals according to the location of the cyst and neurovascular bundles. 7 Most ganglion cysts are on the medial side of the vascular structure. In this technique, the two portals are both posteromedial portals, similar to the technique of Christopher et al.…”
“…We can choose portals according to the location of the cyst and neurovascular bundles. 7 Most ganglion cysts are on the medial side of the vascular structure. In this technique, the two portals are both posteromedial portals, similar to the technique of Christopher et al.…”
“…The procedure was performed by a single surgeon ( initials blinded for review ) according to a predefined, published technique (Fig. 1 ) [ 11 , 12 ]. First, a diagnostic arthroscopy was performed and encountered intra-articular pathologies were treated.…”
Section: Methodsmentioning
confidence: 99%
“…The shaver was introduced through the posteromedial portal and guided subcutaneously to the medial wall of the cyst, which was subsequently excised. Finally, the shaver was pushed into the cyst and other walls of the cyst were excised [ 11 , 12 ]. Fig.…”
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.
“…These methods can provide minimal trauma and certain effect, but there is still a possibility of recurrence [8]. Surgical treatment is mainly based on arthroscopic minimally invasive treatment [9] [10], which treats both a popliteal cyst and the lesions in the knee joint cavity. However, this method poses relatively high requirements for the skills of the operator, with a long learning curve.…”
Objective: The purpose of this study was to explore the clinical efficacy and security of the treatment of popliteal cyst through radiofrequency thermocoagulation (RFT) under ultrasound guidance. Methods: The clinical data of 35 patients with popliteal cyst, who were treated by RFT under ultrasound guidance from June 2019 to June 2020, were retrospectively analyzed. The Visual Analogue Scores (VAS) and the size of cyst before and after treatment were recorded at the first month, the third month, the sixth month. After six months, the recovery rate of Rauschning and Lindgren classification (R-L classification) level 0, 0 -I were counted. All the complications of the patients were observed. Results: 32 patients were followed up for six months. The scores and cyst sizes of each patient before and after the treatment were on a normal distribution curve. There was no significant difference in VAS scores before and after the treatment (P > 0.05). However, there was a significant difference in cyst sizes before and after the treatment (P < 0.05). Moreover, there was no significant difference in VAS scores and cyst sizes in each period after treatment (P > 0.05). According to the R-L classification in 6 months after treatment: the recovery rate of class 0 was 62.5% and class 0 -I level was 87.5%. There were no serious complications in the process. Conclusion: Treatment of popliteal cyst through RFT under ultrasound guidance is a simple, easy, reliable method that is worthy of clinical promotion.
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