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Clinical outcome of arthroscopic management of popliteal cysts with or without additional posterior open cystectomy

Klinisches Outcome der arthroskopischen Behandlung poplitealer Zysten mit und ohne zusätzlicher posteriorer offener Zystektomie

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Abstract

Purpose

The aim of this retrospective study was to compare the clinical outcomes of arthroscopic decompression of popliteal cysts and simultaneous management of intra-articular pathologies alone or in combination with posterior open cystectomy.

Material and methods

This study included 65 consecutive patients with the diagnosis of popliteal cysts. Of the patients 31 received arthroscopy alone (arthroscopic decompression of cysts and management of intra-articular pathologies, AA group) and 34 received arthroscopy combined with open cystectomy (AO group). At the last follow-up after a mean of 33.3 months, magnetic resonance imaging (MRI) scans were performed to assess the outcomes of cysts and functional scores. The Lysholm score and Rauschning and Lindgren grade were used for clinical evaluation.

Results

The procedure in the AA group took less time to perform and resulted in less postoperative complications in the perioperative period. At the last follow-up, no significant differences were observed between the groups in terms of the Lysholm score or Rauschning and Lindgren grade (P > 0.05). The results of MRI showed that the cysts disappeared in 17 (55%) patients, reduced in 9 (29%) patients and persisted in 5 (16%) patients in the AA group, and disappeared in 29 (85%) patients, reduced in 4 (12%) patients and persisted in 1 (3%) patients in the AO group, which was significantly different (P < 0.05). In the AA group 6 patients and 1 in the AO group were grade 2 or 3 and needed a second operation (arthroscopy combined with open cystectomy), which was significantly different (P < 0.05).

Conclusion

In comparison to arthroscopic decompression of cysts and management of intra-articular pathologies alone, the additional posterior open cystectomy reduced the recurrence of popliteal cysts, although it took longer to perform and brought more perioperative complications.

Zusammenfassung

Ziel

Das Ziel dieser retrospektiven Studie war es, die klinischen Ergebnisse der arthroskopischen Dekompression poplitealer Zysten und der gleichzeitigen Behandlung intraartikulärer Pathologien alleine oder in Kombination mit einer posterioren offenen Zystektomie zu vergleichen.

Material und Methoden

In diese Studie wurden 65 konsekutive Patienten mit der Diagnose einer poplitealen Zyste eingeschlossen. Von diesen Patienten erhielten 31 ausschließlich eine Arthroskopie (arthroskopische Dekompression von Zysten und Behandlung intraartikulärer Pathologien, AA-Gruppe), und 34 erhielten eine Arthroskopie in Kombination mit einer offenen Zystektomie (AO-Gruppe). Beim letzten Follow-up nach durchschnittlich 33,3 Monaten wurde eine Magnetresonanztomographie (MRT) durchgeführt, um die Ergebnisse bezüglich der Zysten und die Funktionsscores zu beurteilen. Für die klinische Evaluation wurden der Lysholm-Score und die Gradeinteilung nach Rauschning und Lindgren verwendet.

Ergebnisse

Das Verfahren in der AA-Gruppe nahm weniger Zeit in Anspruch und führte zu weniger postoperativen Komplikationen in der perioperativen Phase. Beim letzten Follow-up wurden keine signifikanten Unterschiede zwischen den Gruppen bezüglich Lysholm-Score und der Gradeinteilung nach Rauschning und Lindgren beobachtet (p > 0,05). Die Ergebnisse der MRT-Untersuchungen zeigten, dass die Zysten in der AA-Gruppe bei 17 (55%) Patienten verschwanden, bei 9 (29%) Patienten reduziert wurden und bei 5 (16%) Patient weiterhin bestanden, während in der AO-Gruppe die Zysten bei 29 (85%) Patienten verschwanden, bei 4 (12%) Patienten reduziert wurden und bei 1 (3%) Patienten weiterhin bestanden, was einen signifikanten Unterschied darstellte (p < 0,05). In der AA-Gruppe wiesen 6 Patienten und in der AO-Gruppe 1 Patient einen Grad 2 oder 3 auf und benötigten eine zweite Operation (Arthroskopie in Kombination mit einer offenen Zystektomie), was einen signifikanten Unterschied darstellte (p < 0,05).

Schlussfolgerung

Im Vergleich zur arthroskopischen Dekompression von Zysten und der Behandlung intraartikulärer Pathologien alleine reduzierte die zusätzliche posteriore offene Zystektomie die Anzahl an Rezidiven poplitealer Zysten, wobei diese Methode mehr Zeit in Anspruch nahm und mehr perioperative Komplikationen nach sich zog.

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Abbreviations

AA:

Arthroscopy alone

AO:

Arthroscopy with open cystectomy

MRI:

Magnetic resonance imaging

NSAID:

Non-steroidal anti-inflammatory drugs

PCL:

Posterior cruciate ligament

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Authors and Affiliations

  1. The Osteopathy Department, the Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University, Wenzhou, Zhejiang Province, China

    Xu Xinxian, Hu Yuezheng, Lin Jian & Yu Huachen

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  1. Xu Xinxian
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  2. Hu Yuezheng
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  3. Lin Jian
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  4. Yu Huachen
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Corresponding author

Correspondence to Yu Huachen.

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Conflict of interest

X. Xinxian, H. Yuezheng, L. Jian and Y. Huachen declare that they have no competing interests.

This article does not contain any studies with human participants or animals performed by any of the authors.

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Xinxian, X., Yuezheng, H., Jian, L. et al. Clinical outcome of arthroscopic management of popliteal cysts with or without additional posterior open cystectomy. Orthopäde 47, 530–535 (2018). https://doi.org/10.1007/s00132-018-3573-0

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