New insights into the development of popliteal cysts

Labropoulos, Nicos; Shifrin, David A.; Paxinos, Odysseas

doi:10.1002/bjs.4635

Cited by 48 publications

(32 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Intervention can be surgical or conservative, depending on whether there is precipitating knee injury ultimately responsible for the development of the cyst. 8,41 Because rupture of the cyst may lead to the development of a critical compartment syndrome, patients with an elevated risk to develop venous thrombosis and pulmonary embolism should be carefully monitored because their management and treatment is informed by their potential to bleed into a synovial cyst. A complete differential diagnosis for pseudothrombophlebitic syndrome of the lower limb that includes a Baker cyst should involve venous duplex scanning and ultrasound imaging to rule out thrombosis and avoid unnecessary anticoagulation and potential bleeding into the cyst.…”

Section: Discussionmentioning

confidence: 99%

“…A 2004 prospective study designed to investigate the etiology of this cyst concluded that a popliteal cyst usually develops in the posteromedial popliteal fossa due to lack of anatomic support in this area of the synovial capsule. 8 The accumulation of fluid within the bursa in this medial anatomic location within the knee typically spares the posterolaterally located neurovascular bundle.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Compression syndromes of the popliteal neurovascular bundle due to Baker cyst

Sánchez

Conkling

Labropoulos

2011

Journal of Vascular Surgery

View full text Add to dashboard Cite

Background: The purpose of this study was to perform a comprehensive search of the literature for all studies, case reports, and series describing Baker cyst compression of the neurovascular bundle in the popliteal fossa and index their findings according to the structures compressed. Method: Case reports and series obtained after a thorough MEDLINE search were indexed according to compressed structures. Patient demographics, main findings, method of diagnosis, cyst size, outcomes, and follow-up were recorded for each publication. Results: Signs and symptoms related to popliteal vein and tibial nerve compression were the most frequent presentation of symptomatic Baker cysts, due to the anatomic vulnerability of these structures within the popliteal fossa and their relative sensitivity to compression. Patients with tibial nerve entrapment demonstrated gastrocnemius muscle atrophy, paresthesias, and pain. Those with popliteal vein compression experienced swelling, pain, and rarely, venous thromboembolism. Isolated arterial compression, presenting with intermittent claudication, is a rare occurrence because it is a relatively stiff-walled vessel, has a higher pressure, and is located deep in the popliteal fossa. Combinations of these compression syndromes are most frequently encountered in the context of cyst rupture and resulting compartment syndrome. Conclusions: Baker cyst is an important pathology for the differential diagnosis of popliteal neurovascular compression phenomena. It has a wide spectrum of presentation, therefore requiring accurate diagnosis for proper patient management. Because Baker cyst is by definition a chronic disorder, long-term follow-up is necessary to monitor patient recovery and prevent recurrence. ( J Vasc Surg 2011;54:1821-9.)

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Compression syndromes of the popliteal neurovascular bundle due to Baker cyst

Sánchez

Conkling

Labropoulos

2011

Journal of Vascular Surgery

View full text Add to dashboard Cite

show abstract

“…The pathogenesis of synovial cyst of knee joint is explained by the presence of a communication between the joint and the bursa, continuous unidirectional flow via the valvular mechanism and unequal pressure between the joint and bursa during various knee movements [3][4][5]. Addressing these factors during the operative treatment of synovial cyst is important to prevent recurrence [12].…”

Section: Discussionmentioning

confidence: 99%

Giant synovial cyst of knee treated arthroscopically through a cystic portal

Shetty

Wang

Ahn

et al. 2007

Knee Surg Sports Traumatol Arthr

View full text Add to dashboard Cite

Synovial cysts are well-defined fluid filled cysts that can extend for a variable distance outside the joint space. These cysts can sometimes grow to a large size making its treatment challenging especially when associated with intra-articular pathologies. We describe a case of giant synovial cyst arising from the left knee and extending to the medial proximal calf in a 77-year old female who presented with knee joint pain, episodes of locking and calf mass occurring within 2 months of onset. Imaging studies also showed associated medial and lateral meniscal tears with medial compartment and patellofemoral osteoarthritis. The cyst was treated by disrupting the valvular mechanism using a standard posteromedial portal and complete excision of the cyst wall via a posteromedial cystic portal. The meniscal lesions were dealt with through the standard anterior portals. At 25-month follow up there were no signs of recurrence of the cyst clinically or with MRI. The cystic portal technique is effective in treating a giant synovial cyst of the knee even in the presence of meniscal tears and high grade chondral lesions.

show abstract

“…1 They can occur due to intraarticular pathology, including meniscal and anterior cruciate ligament tears, chondral lesions, and synovitis. 2 The underlying or associated intra-articular pathology must be addressed to prevent recurrence of the cyst.Surgical removal of popliteal cysts is indicated in rare cases when the cyst remains symptomatic despite treatment of intra-articular pathology or if no underlying cause is found. Historically, open surgical excision has been performed through a posterior approach or posteromedial approach.…”

mentioning

confidence: 99%

mentioning

confidence: 99%

Popliteal Cyst Excision Using Open Posterior Approach After Arthroscopic Partial Medial Meniscectomy

Snir

Hamula

Wolfson

et al. 2013

Arthroscopy Techniques

View full text Add to dashboard Cite

Popliteal cysts are known to be associated with intra-articular pathology, which must be addressed to prevent cyst recurrence. Indications for popliteal cyst excision include cases in which the popliteal cyst does not respond to conservative treatment or arthroscopic intervention or cases in which an underlying cause cannot be found. Several techniques have been described to excise these cysts. Traditionally, open techniques have been associated with cyst recurrence. More recently, arthroscopic cystectomy has been described. However, the risk of recurrence persists because arthroscopy may not afford complete surgical excision. This technical note presents an open posterior technique for popliteal cyst excision that allows for better visualization and complete removal of the cyst while minimizing the risk of neurovascular complications and soft-tissue damage. It is a safe, effective, and straightforward method to achieve symptomatic relief for refractory popliteal cysts.P opliteal cysts, also known as Baker cysts, are fluidfilled structures with a synovial lining typically located between the medial head of the gastrocnemius muscle and semimembranosus tendon. Although some popliteal cysts maintain a unidirectional valve communication with the joint cavity, preventing shifting of fluid from the cyst back into the knee joint, others communicate freely. 1 They can occur due to intraarticular pathology, including meniscal and anterior cruciate ligament tears, chondral lesions, and synovitis. 2 The underlying or associated intra-articular pathology must be addressed to prevent recurrence of the cyst.Surgical removal of popliteal cysts is indicated in rare cases when the cyst remains symptomatic despite treatment of intra-articular pathology or if no underlying cause is found. Historically, open surgical excision has been performed through a posterior approach or posteromedial approach. 1,3 Arthroscopic closure of the valve without removal of the cyst has shown poor results. [4][5][6] Arthroscopic valve closure with cyst excision has been described through a posteromedial cyst portal with good preliminary results. 7,8 However, there is still no surgical standard of care for patients with refractory cysts, and concern for recurrence persists.This technical note presents an open posterior technique for popliteal cyst excision that allows for complete removal of the cyst while minimizing the risk of neurovascular complications and soft-tissue damage. It is a safe, effective, and simple method to achieve symptomatic relief for refractory popliteal cysts. Surgical TechniqueThis technique is indicated for cases in which the intra-articular pathology associated with popliteal cysts has been corrected and patients continue to have symptoms from the popliteal cyst without an associated intra-articular lesion. Popliteal cyst excision is always preceded by knee arthroscopy to evaluate for recurrent intra-articular pathology. Popliteal cyst excision is not recommended as a first-line treatment for symptomatic knees. Most...

show abstract

New insights into the development of popliteal cysts

Abstract: Popliteal cysts are relatively common in patients over 50 years old with a painful knee or with signs and symptoms of DVT. They form in the posteromedial popliteal fossa because the synovial capsule does not provide anatomical support in this region.

Cited by 48 publications

References 29 publications

Compression syndromes of the popliteal neurovascular bundle due to Baker cyst

Compression syndromes of the popliteal neurovascular bundle due to Baker cyst

Giant synovial cyst of knee treated arthroscopically through a cystic portal

Popliteal Cyst Excision Using Open Posterior Approach After Arthroscopic Partial Medial Meniscectomy

Contact Info

Product

Resources

About