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

Abstract

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.

A Case Series on Arthroscopic Valvulectomy of Symptomatic Popliteal Cysts in Elderly Patients Using a Modified Gillquist Maneuveropic Valvulectomy of Symptomatic Popliteal Cysts in Elderly Patients Using a Modified Gillquist Maneuver

“…12 These scores have been used to evaluate outcomes in patients with symptomatic popliteal cysts who underwent arthroscopic cystectomy and valve excision. 13 Malinowski et al, concluded that there was an improvement in the postoperative Rauschning and Lindgren Criteria and Lysholm in patients who underwent arthroscopic cystectomy and valve excision of the symptomatic popliteal cyst.…”

Popliteal Cyst Compressive Tibial Neuropathy and Venous Insufficiency: A Case Report

“…Open and arthroscopic surgical treatments have both been described as viable options for decompression of popliteal cysts and both have good success rates in preventing recurrence. Arthroscopic cystectomy with valve excision recurrence rate is reported at 12.4% [ 5 ]. Saylik et al, on the other hand, reported a popliteal cyst recurrence rate of 1.94% in their series after open cyst excision with stalk closure [ 6 ].…”

Arthroscopic Trans-septal Portal of the Knee With Direct Visualization and No Need for Posterolateral Portal Creation

“…Among such procedures are removal of posterior pathologic findings (i.e., loose bodies, tumors, cysts), PCL reconstruction and repair, repair of the posterior meniscal horns, and posterior capsular release for extension contracture. 1 , 4 , 6 , 8 , 9 , 10 , 11 , 12 , 13 …”