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Comparisons between treatment of isolated posterosuperior paralabral cysts and simultaneous treatment of cysts combined with associated shoulder pathologies: arthroscopic treatment of posterosuperior paralabral cysts

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

The purpose of this study is to report the radiologic and clinical outcomes of arthroscopic intervention for isolated posterosuperior paralabral cysts and simultaneous treatment of cysts combined with associated shoulder pathologies.

Materials and methods

From March 2008 through December 2016, 70 cases (48 males and 22 females) operated on for symptomatic posterosuperior paralabral cysts were included. Mean age was 45 (range 18–69). These patients were classified into two groups depending on if they had accompanying lesions: Group I (isolated group, 27 patients) and Group II (concomitant group, 43 patients). Arthroscopic cyst decompression with a labral repair or posterior capsulotomy for patients without labral tear were performed. All concomitant pathologies were also operated simultaneously. Follow-up MRI were performed at postoperative 6 months and clinical outcomes were evaluated during the follow-up.

Results

Arthroscopic all intra-articular cyst decompression and labral repair was performed on 67 patients. In three patients, posterior capsulotomy without labral repair was performed for cyst removal. For 43 patients with concomitant lesions, 31 rotator cuff repairs, three SLAP repairs along with biceps tenodesis, two distal clavicle resections due to A–C joint arthritis, one calcific deposit removal, four Bankart repairs, and two acromioplasties were performed. The follow-up MRI showed complete cyst resorption except for two patients. The mean VAS, ASES, UCLA, SST and CS scores significantly improved at the last follow-up. Although both groups showed significantly improved range of motion after the surgery, improvement of ROM in Group II lagged at early periods of the rehabilitation.

Conclusions

Arthroscopic labral repair with all intra-articular cysts decompression or simple posterior capsulotomy were both effective treatment modalities. If paralabral cysts were associated with other shoulder lesions, simultaneous treatment of combined lesions could be performed for the improved clinical outcomes at final follow-up with expected lag in the early rehabilitation period.

Level of evidence

Level III, Retrospective Comparative Trial, Treatment Study

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References

  1. Aydin N, Unal MB, Asansu M, Tok O (2017) Concomitant SLAP repair does not influence the surgical outcome for arthroscopic Bankart repair of traumatic shoulder dislocations. J Orthop Surg (Hong Kong) 25(2):2309499017718952

    Article  PubMed  Google Scholar 

  2. Catalano JB, Fenlin JM Jr (1994) Ganglion cysts about the shoulder girdle in the absence of suprascapular nerve involvement. J Shoulder Elbow Surg 3(1):34–41

    Article  CAS  PubMed  Google Scholar 

  3. Chen AL, Ong BC, Rose DJ (2003) Arthroscopic management of spinoglenoid cysts associated with SLAP lesions and suprascapular neuropathy. Arthroscopy 19(6):E15-21

    Article  PubMed  Google Scholar 

  4. Chochole MH, Senker W, Meznik C, Breitenseher MJ (1997) Glenoid-labral cyst entrapping the suprascapular nerve: dissolution after arthroscopic debridement of an extended SLAP lesion. Arthroscopy 13(6):753–755

    Article  CAS  PubMed  Google Scholar 

  5. Cvetanovich GL, Gowd AK, Liu JN et al (2019) Establishing clinically significant outcome after arthroscopic rotator cuff repair. J Shoulder Elbow Surg 28(5):939–948

    Article  PubMed  Google Scholar 

  6. Fankhauser F, Schippinger G (2002) Suprascapular nerve entrapment by a ganglion cyst: an alternative method of treatment. Orthopedics 25(1):87–88

    Article  PubMed  Google Scholar 

  7. Fehrman DA, Orwin JF, Jennings RM (1995) Suprascapular nerve entrapment by ganglion cysts: a report of six cases with arthroscopic findings and review of the literature. Arthroscopy 11(6):727–734

    Article  CAS  PubMed  Google Scholar 

  8. Ghodadra N, Nho SJ, Verma NN et al (2009) Arthroscopic decompression of the suprascapular nerve at the spinoglenoid notch and suprascapular notch through the subacromial space. Arthroscopy J Arthrosc Relat Surg 25(4):439–445

    Article  Google Scholar 

  9. Hantes ME, Venouziou AI, Liantsis AK, Dailiana ZH, Malizos KN (2009) Arthroscopic repair for chronic anterior shoulder instability: a comparative study between patients with Bankart lesions and patients with combined Bankart and superior labral anterior posterior lesions. Am J Sports Med 37(6):1093–1098

    Article  PubMed  Google Scholar 

  10. Harris JD, Brand JC, Cote MP, Faucett SC, Dhawan A (2017) Research pearls: the significance of statistics and perils of pooling. Part 1: clinical versus statistical significance. Arthroscopy 33(6):1102–1112

    Article  PubMed  Google Scholar 

  11. Iannotti JP, Ramsey ML (1996) Arthroscopic decompression of a ganglion cyst causing suprascapular nerve compression. Arthroscopy 12(6):739–745

    Article  CAS  PubMed  Google Scholar 

  12. Jeong JJ, Panchal K, Park SE et al (2015) Outcome after arthroscopic decompression of inferior labral cysts combined with labral repair. Arthroscopy 31(6):1060–1068

    Article  PubMed  Google Scholar 

  13. Ji JH, Shafi M, Lee YS, Kim DJ (2012) Inferior paralabral ganglion cyst of the shoulder with labral tear—a rare cause of shoulder pain. Orthop Traumatol Surg Res 98(2):193–198

    Article  PubMed  Google Scholar 

  14. Kim DS, Park HK, Park JH, Yoon WS (2012) Ganglion cyst of the spinoglenoid notch: comparison between SLAP repair alone and SLAP repair with cyst decompression. J Shoulder Elbow Surg 21(11):1456–1463

    Article  PubMed  Google Scholar 

  15. Leitschuh PH, Bone CM, Bouska WM (1999) Magnetic resonance imaging diagnosis, sonographically directed percutaneous aspiration, and arthroscopic treatment of a painful shoulder ganglion cyst associated with a SLAP lesion. Arthroscopy 15(1):85–87

    Article  CAS  PubMed  Google Scholar 

  16. Lichtenberg S, Magosch P, Habermeyer P (2004) Compression of the suprascapular nerve by a ganglion cyst of the spinoglenoid notch: the arthroscopic solution. Knee Surg Sports Traumatol Arthrosc 12(1):72–79

    Article  PubMed  Google Scholar 

  17. Moon CY, Ji JH, Kim SJ (2010) Multidirectional instability accompanying an inferior labral cyst. Clin Orthop Surg 2(2):121–124

    Article  PubMed  PubMed Central  Google Scholar 

  18. Moore TP, Fritts HM, Quick DC, Buss DD (1997) Suprascapular nerve entrapment caused by supraglenoid cyst compression. J Shoulder Elbow Surg 6(5):455–462

    Article  CAS  PubMed  Google Scholar 

  19. Park JH, Lee YS, Park JW, Yoo JC, Kang JW, Park JS (2010) Effective arthroscopic treatment of large, anteriorly extended spinoglenoid cysts. Arch Orthop Trauma Surg 130(3):423–426

    Article  PubMed  Google Scholar 

  20. Phillips CJ, Field AC, Field LD (2018) Transcapsular decompression of shoulder ganglion cysts. Arthrosc Tech 7(12):e1263–e1267

    Article  PubMed  PubMed Central  Google Scholar 

  21. Piatt BE, Hawkins RJ, Fritz RC, Ho CP, Wolf E, Schickendantz M (2002) Clinical evaluation and treatment of spinoglenoid notch ganglion cysts. J Shoulder Elbow Surg 11(6):600–604

    Article  PubMed  Google Scholar 

  22. Pillai G, Baynes JR, Gladstone J, Flatow EL (2011) Greater strength increase with cyst decompression and SLAP repair than SLAP repair alone. Clin Orthop Relat Res 469(4):1056–1060

    Article  PubMed  Google Scholar 

  23. Purohit S, Keny S, Raja B, Marathe N (2019) Massive acromio-clavicular joint ganglion cyst associated with cuff tear arthropathy and acromioclavicular joint arthritis with normal functional shoulder—a case report. J Clin Orthop Trauma 10(3):522–525

    Article  PubMed  PubMed Central  Google Scholar 

  24. Rachbauer F, Sterzinger W, Frischhut B (1996) Suprascapular nerve entrapment at the spinoglenoid notch caused by a ganglion cyst. J Shoulder Elbow Surg 5(2 Pt 1):150–152

    Article  CAS  PubMed  Google Scholar 

  25. Romeo AA, Rotenberg DD, Bach BR Jr (1999) Suprascapular neuropathy. J Am Acad Orthop Surg 7(6):358–367

    Article  CAS  PubMed  Google Scholar 

  26. Sanders TG, Tirman PF (1999) Paralabral cyst: an unusual cause of quadrilateral space syndrome. Arthroscopy 15(6):632–637

    Article  CAS  PubMed  Google Scholar 

  27. Schroder CP, Skare O, Stiris M, Gjengedal E, Uppheim G, Brox JI (2008) Treatment of labral tears with associated spinoglenoid cysts without cyst decompression. J Bone Jt Surg Am 90(3):523–530

    Article  Google Scholar 

  28. Shon MS, Jung SW, Kim JW, Yoo JC (2015) Arthroscopic all-intra-articular decompression and labral repair of paralabral cyst in the shoulder. J Shoulder Elbow Surg 24(1):e7–e14

    Article  PubMed  Google Scholar 

  29. Takase K (2009) Risk of motion loss with combined Bankart and SLAP repairs. Orthopedics 32(8)

  30. Tirman PF, Feller JF, Janzen DL, Peterfy CG, Bergman AG (1994) Association of glenoid labral cysts with labral tears and glenohumeral instability: radiologic findings and clinical significance. Radiology 190(3):653–658

    Article  CAS  PubMed  Google Scholar 

  31. Tung GA, Entzian D, Stern JB, Green A (2000) MR imaging and MR arthrography of paraglenoid labral cysts. AJR Am J Roentgenol 174(6):1707–1715

    Article  CAS  PubMed  Google Scholar 

  32. Wang DH, Koehler SM (1996) Isolated infraspinatus atrophy in a collegiate volleyball player. Clin J Sport Med 6(4):255–258

    Article  CAS  PubMed  Google Scholar 

  33. Warner JP, Krushell RJ, Masquelet A, Gerber C (1992) Anatomy and relationships of the suprascapular nerve: anatomical constraints to mobilization of the supraspinatus and infraspinatus muscles in the management of massive rotator-cuff tears. J Bone Jt Surg Am 74(1):36–45

    Article  CAS  Google Scholar 

  34. Youm T, Matthews PV, El Attrache NS (2006) Treatment of patients with spinoglenoid cysts associated with superior labral tears without cyst aspiration, debridement, or excision. Arthroscopy 22(5):548–552

    Article  PubMed  Google Scholar 

  35. Yukata K, Imada K, Yoshizumi Y, Tamano K, Hosokawa S, Nakaima N (2002) Intra-articular ganglion cyst (paralabral cyst) of the shoulder associated with recurrent anterior dislocation: a case report. J Shoulder Elbow Surg 11(1):95–97

    Article  PubMed  Google Scholar 

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Funding

This research received no specific Grant from any funding agency in the public, commercial or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Deajeon St. Mary’s Hospital, The Catholic University of Korea, Daejeon, Republic of Korea

    Jong-Hun Ji, Sang-Eun Park, Dong-Whan Suh & Young Hoon Han

  2. Department of Orthopaedic Surgery, St. Vincent’s Hospital , The Catholic University of Korea, 93 Jungbudaero, Paldal-gu, Suwon, 16247, Republic of Korea

    Seungbae Oh

  3. Department of Orthopaedic Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

    Jong-Hun Ji, Sang-Eun Park, Dong-Whan Suh, Young Hoon Han & Seungbae Oh

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  1. Jong-Hun Ji
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  2. Sang-Eun Park
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Seungbae Oh.

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Ji, JH., Park, SE., Suh, DW. et al. Comparisons between treatment of isolated posterosuperior paralabral cysts and simultaneous treatment of cysts combined with associated shoulder pathologies: arthroscopic treatment of posterosuperior paralabral cysts. Arch Orthop Trauma Surg 143, 665–675 (2023). https://doi.org/10.1007/s00402-021-04128-z

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