Endoscopic excision of a ganglion cyst in an infrapatellar fat pad extending into the subcutaneous layer

Yang, Jae Hyuk; Kim, Taik Sun; Lim, Hong Chul; Kim, Soo Hyun; Kim, Yoonjung; Oh, Chi Hun; Yoon, Jung Hwan

doi:10.1007/s00776-011-0099-2

Cited by 3 publications

(1 citation statement)

References 20 publications

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“…In case of ganglion cysts in the infrapatellar fat pad of the knee, it is difficult to reach the cyst arthroscopically although Yang et al . reported an endoscopic resection of a ganglion cyst in an infrapatellar fat pad extending into the subcutaneous layer [ 14 ]. Bisicchia et al reported the recurrence of infrapatellar fat pad cysts after ultrasound-guided aspiration [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

A Case of Infrapatellar Fat Pad Ganglion of the Knee

Takahashi

Kimura

Ohsawa

et al. 2017

TOORTHJ

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Introduction:A ganglion cyst can induce symptoms around the knee and should be considered as an intra-articular mass in differential diagnosis.Case Presentation:A 22-year-old female presented with a persistent medial knee joint pain in her left knee for 2 years. There was soft tissue swelling on the anteromedial aspect of the infrapatellar region on her left knee. Lachman and McMurray tests were negative. MRI showed a multilobular cyst in the infrapatellar fat pad with T1 low intensity and T2 STIR high intensity. The cyst was not attached to either meniscus. ACL and PCL looked normal.During surgery, the cyst was found to arise from the intra-patellar fat pad and was not attached to the menisci or synovium. The cyst was completely resected.Histological findings showed a multilobular cyst with a glassy fibrous tissue wall and clear jelly-like consistency, confirming the diagnosis of a ganglion. The patient recovered asymptomatically and has been without recurrence 7 years postoperatively.Conclusion:Differential diagnoses of an infrapatellar swelling are a meniscal cyst, synovial cyst, or ganglion. Most cases of cysts around the knee generate from fluid collection through meniscal tears. A ganglion cyst is a synovium-lined structure and is common around the wrist joint, but rare in the knee joint. A ganglion cyst in the knee joint often arises from ACL or PCL, but rarely arises from the infrapatellar fat pad. A ganglion cyst is one of the differential diagnoses of parameniscal cysts around the knee. We recommended an open resection with arthroscopic examination.

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Section: Discussionmentioning

confidence: 99%

A Case of Infrapatellar Fat Pad Ganglion of the Knee

Takahashi

Kimura

Ohsawa

et al. 2017

TOORTHJ

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Térdközeli lateralis cystosus elváltozások differenciáldiagnosztikája

2019

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Soft tissues detected on the lateral side of the knee joint may have differential diagnostic difficulties. Although most of these are benign, mostly cystic in appearance, they may raise the clinical suspicion of tumors due to their increased growth. The authors describe two rare soft tissue changes in three patients. They review the diagnostic procedures most commonly used in daily care, present surgical options, and discuss the literature of the subject. Orv Hetil. 2019; 160(15): 593–599.

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Ganglion cyst arising from the infrapatellar fat pad in a child

et al. 2015

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A ganglion cyst is a cystic swelling containing myxoid matrix and lined by a pseudomembrane (1, 2). These cysts sometimes occur in the knee, mainly arising from the synovial membrane of ligaments. The prevalence of intra-articular ganglion cyst of the knee ranges from 0.2% to 1% as determined by magnetic resonance imaging (MRI) and 0.6% as determined by arthroscopy (3). A ganglion cyst arising from the infrapatellar fat pad is very rare ; only a few cases have been reported to date (4, 5) and age in these cases ranged from 22 to 77 years. Here, we describe the case of a pediatric patient with a ganglion cyst arising from the infrapatellar fat pad, which was treated by arthroscopic excision. CASE PRESENTATIONA 10-year-old boy complained of right knee pain without any triggers. He had no traumatic or infectious history in the affected knee. He was physically active ; he practiced the martial art Shorinji Kempo and played golf. He consulted a family doctor when the pain did not improve for 1 month. MRI revealed an intra-articular mass in the right knee, and the patient was referred to our department for further examination.At presentation to us, alignment of the lower limbs was normal. Range of motion (ROM) of the right knee was slightly limited in extension compared with the opposite side. The patellofemoral joint line was tender, but there was no swelling or localized warmth on the knee. The McMurray, Lachman, and varus/valgus stress tests were all negative. Although plain radiographs were normal, MRI showed a multilobular cystic lesion between the infrapatellar fat pad and anterior cruciate ligament (ACL) (Figure 1). The mass measured approximately 30 mm! 15 mm! 20 mm and was well circumscribed, with low intensity on T1 -weighted images and high to iso-intensity on T2-weighted and fat-suppressed T2-weighted images. The origin of the mass was unclear. The ACL showed no abnormal intensity on MRI.We considered ganglion cyst, parameniscal cyst, lipoma, hemangioma, pigmented villonodular synovitis (PVNS), and synovial sarcoma as a differential diagnosis. We considered this lesion was unlikely to be synovial sarcoma because the multilobular cystic lesion existed intraarticularly and has no calcification in this case. For diagnostic treatment, arthroscopic excision of the mass was performed. Superolateral, anterolateral, and anteromedial portals were used. At the beginning of the operation, we inserted the arthroscope into the superolateral portal to observe the entire mass in one field with reference to the preoperative MR images. Arthroscopy revealed a multilobular cystic mass covered with a thin capsule. It arose not from the ACL but from the infrapatellar fat pad. The mass was filled with myxoid matrix with a jelly-like consistency. No injuries to the cartilage, ligaments, or meniscuses were evident. The synovial tissue was hyperplastic around the anterior and lateral spaces of the groove. We also confirmed the impingement of the mass between the femur and infrapatellar fat pad during the knee extension. The cystic...

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Endoscopic excision of a ganglion cyst in an infrapatellar fat pad extending into the subcutaneous layer

Cited by 3 publications

References 20 publications

A Case of Infrapatellar Fat Pad Ganglion of the Knee

A Case of Infrapatellar Fat Pad Ganglion of the Knee

Térdközeli lateralis cystosus elváltozások differenciáldiagnosztikája

Ganglion cyst arising from the infrapatellar fat pad in a child

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