Arthroscopic Management of Meniscal Cysts: A Systematic Review

Abstract

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nonoperative modalities, given that a significant proportion of the included articles in this review were relatively outdated.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.

Arthroscopic Management of Giant Meniscal Cysts Among Young Patients: An Average Three‐YearMRIFollow‐Up

“…Giant meniscal cyst management raises considerable controversy 15 , as some clinicians still believe that conservative management with follow‐up is the best option for asymptomatic cases. Traditional treatment, including open cystectomy, complete or partial meniscectomy, arthroscopic meniscus repair, and cyst excision, is the best method of management.…”

Do meniscal repairs with meniscus cyst do better than meniscectomy?—a systematic review of meniscal cyst treatment

“…Co-existing meniscal tears, if found, were mostly debrided until a stable rim was achieved ( 4 , 15 - 17 ). A recent systematic review by Haratian et al ( 18 ) showed that arthroscopic management of cysts can provide satisfactory outcomes for patients with good return to sport. However, it is not clear whether the treatment of the co-existing meniscal tears can affect the outcomes achieved.…”

Сучасні Підходи До Лікування Кіст Мінісків Огляд Літератури)

“…Описані різні методики артроскопічної декомпресії. Ранні артроскопічні процедури в основному були зосереджені на простій евакуації вмісту кісти в порожнину суглоба [9,10]. Черезшкірна декомпресія за допомогою голки малого .…”

“…У цьому огляді середньозважений показник за шкалою Лайзхольма для всіх артроскопічних процедур становив 77,7 бала, і в нього були включені майже всі дані про кісти латерального меніска. Найбільшу вагу для розрахунку середньозважених балів за шкалою Лайзхольма в цьому огляді мали дані одного дослідження, які повідомили про 72,4 та 74 бали за шкалою Лайзхольма для артроскопічної декомпресії та висічення відповідно [18].…”