Clinical manifestation and arthroscopic treatment of symptomatic posterior cruciate ligament cyst

Abstract

BackgroundGanglion cyst of cruciate ligaments is a rare lesion; the prevalence is 0.3–0.8%. The purpose of this study was to present clinical features of symptomatic posterior cruciate ligament (PCL) cyst, introduce the arthroscopic excision technique, and evaluate the clinical outcome.MethodsA series of 11 patients with symptomatic PCL cyst from November 2012 to December 2014 were involved in this retrospective study. Detailed medical history collecting and physical examination were conducted. Magnetic resonance imaging (MRI) scan was used to confirm the diagnosis. Arthroscopic resection was performed, and the sample of the cyst was taken for pathologic examination. The follow-up averaged 30.7 months. International Knee Documentation Committee (IKDC) score, the range of motion (ROM), and MRI evaluations were obtained pre- and postoperatively to assess the surgical outcome. SPSS software was used for statistics analysis.ResultsEight males and 3 females with 6 left knees and 5 right knees were enrolled, the mean age was 34.4 years, and the duration of symptom was 19.0 months. All cases had a definite history of knee trauma or injury. The most common symptom was knee pain at flexion or in flexion-associated activities. MRI revealed the location and size of the cyst in each case. Pathologic examination showed the cyst wall was composed of dense fibroconnective tissue and widespread thick bundles of collagen, which is similar to the structure of ganglion cyst. At the final follow-up, MRI evaluation showed no cyst recurrence. The preoperative ROM and IKDC score were 2.3° to 108.6° and 40.5 ± 11.3, respectively, compared with the postoperative ROM and IKDC score which were 0° to 134.1° and 85.5 ± 4.8 (p < 0.05) separately.ConclusionsWe conclude that the etiology of symptomatic PCL cyst is most likely associated with trauma, pain on flexion is a typical manifestation of symptomatic PCL cyst, MRI evaluation is an ideal examination for the diagnosis, and arthroscopic resection of symptomatic PCL cysts has a good outcome with no recurrence.Electronic supplementary materialThe online version of this article (10.1186/s13018-018-0798-x) contains supplementary material, which is available to authorized users.

Excision of a Posterior Cruciate Ligament Cyst Using an Arthroscopic Trans-septal Approach

“…Their etiology is still unclear, but they seem to be associated mostly with trauma or chronic injuries. 1,4 The main symptom of PCL cysts is knee pain during flexion. MRI is the gold standard to detect and accurately locate cysts associated with cruciate ligaments in the knee.…”

“…However, several studies have shown that the cyst walls are not removed with these procedures, leading to a potentially higher risk of recurrence. 1,3,6 The cyst walls can be removed completely using an arthroscopic procedure, although this is technically challenging to perform using anterior portals only.…”

“…Not all PCL cysts are symptomatic; however, in a few cases, they may be clinically relevant, causing knee pain and limiting flexion. [1][2][3] Most PCL cysts are found fortuitously by ultrasound, magnetic resonance imaging (MRI), or arthroscopy performed for other pathologies of the knee. [3][4][5][6][7] Initial treatment with medication and corticosteroid injections resolves most cases.…”

Diagnosis and Treatment of a Symptomatic Posterior Cruciate Ganglion Cyst in a Child with Autism

“…Those lesions are mainly diagnosed in patients aged between 20 and 40 years [ 3 , 5 , 6 ], and a male preponderance has been reported [ 5 ].…”

Painfull Posterior Cruciate Ligament Ganglion Cyst. A Case Report

“…Ganglion cysts (GC) are benign tumor-like lesions usually going out from mucinous degeneration of collagenous structures [1,2]. They could occur in several anatomic areas but GC arising from cruciate ligaments are rare [3,4] with a prevalence of 0.36% or 0.8% respectively when diagnosed by magnetic resonance (MR) or by arthroscopy [3,[5][6] However other studies of GC prevalence refer ranges from 0.2% to 1.9% [7][8][9], with posterior cruciate ligament ganglion cysts (PCLGC) being five times less frequent than those identify in anterior cruciate ligament [5,10]. This lesion is mainly diagnosed in people aged 20-40 years-old and a male predominance has been reported [5,[11][12][13].…”