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The Journal of Arthroplasty Dec 2003We present a case exhibiting persistent joint effusion and formation of a gigantic popliteal synovial cyst 8 years after total knee joint arthroplasty. Assessment using...
We present a case exhibiting persistent joint effusion and formation of a gigantic popliteal synovial cyst 8 years after total knee joint arthroplasty. Assessment using flow cytometry revealed that both joint and cyst fluid contained abundant macrophage-phagocytosing wear particles. This finding indicates that wear particles participated in formation of the cyst through the communication between the joint cavity and cyst. Intraoperatively, prominent villous synovial proliferation was observed in both the joint and cyst, and delamination failure of the polyethylene insert was identified. Because no evidence of prosthetic loosening was found, only polyethylene insert revision and synovectomy were undertaken, resulting in a successful outcome. This case suggests that synovial cyst formation in popliteal lesions might represent a sign of wear-particle generation after total knee joint arthroplasty.
Topics: Aged; Arthroplasty, Replacement, Knee; Female; Flow Cytometry; Humans; Osteolysis; Popliteal Cyst; Synovial Fluid; Synovitis
PubMed: 14658115
DOI: 10.1016/s0883-5403(03)00328-0 -
Klinichna Khirurhiia Jan 2012
Review
Topics: Arthroscopy; Humans; Knee Joint; Popliteal Cyst; Ultrasonography
PubMed: 22642093
DOI: No ID Found -
Arthroscopy : the Journal of... Feb 1997The purpose of this study was to establish the incidence of the anatomic structure, the popliteal bursa, in patients undergoing arthroscopy and to determine the...
The purpose of this study was to establish the incidence of the anatomic structure, the popliteal bursa, in patients undergoing arthroscopy and to determine the relationship to associated clinical and pathological factors. Diagnostic arthroscopy was used to identify the presence of the popliteal bursa in 187 consecutive patients (195 knees). Thirty-seven percent of knees had a popliteal bursa identified by the communication with the posterior medial compartment. The cause of the popliteal bursa was not established by this study. This study refuted the causes proposed by others. The existing erroneous conclusions concerning the cause of the popliteal bursa were probably attributable to the failure to recognize the common continuity of the bursa and the knee joint. When the popliteal bursa is present (37%), it becomes symptomatic by responding to the intraarticular disease because of its continuity with the knee joint.
Topics: Adult; Arthroscopy; Endoscopy; Female; Humans; Incidence; Male; Popliteal Cyst; Prospective Studies
PubMed: 9043606
DOI: 10.1016/s0749-8063(97)90211-5 -
International Orthopaedics Jun 2023Arthroscopy in popliteal cyst surgery enables addressing all components of its pathomechanism: the cyst wall, valvular mechanism, and concomitant intra-articular...
Arthroscopic cystectomy and valve excision of popliteal cysts complemented with management of intra-articular pathologies: a low recurrence rate and good functional outcomes in a series of ninety seven cases.
PURPOSE
Arthroscopy in popliteal cyst surgery enables addressing all components of its pathomechanism: the cyst wall, valvular mechanism, and concomitant intra-articular pathologies. Techniques differ as to the management of the cyst wall and the valvular mechanism. This study aimed to assess the recurrence rate and functional outcomes of a cyst wall and valve excising arthroscopic technique with concurrent intra-articular pathology management. The secondary purpose was to assess cyst and valve morphology and concomitant intra-articular findings.
METHODS
Between 2006 and 2012, 118 patients with symptomatic popliteal cysts refractory to at least three months of guided physiotherapy were operated on by a single surgeon using a cyst wall and valve excising arthroscopic technique with intra-articular pathology management. Patients were evaluated preoperatively and at a mean follow-up of 39 months (range 12-71) by ultrasound, Rauschning and Lindgren, Lysholm, and VAS of perceived satisfaction scales.
RESULTS
Ninety-seven out of 118 cases were available for follow-up. Recurrence was observed on ultrasound in 12/97 cases (12.4%); however, it was symptomatic only in 2/97 cases (2.1%). Mean scores improved: Rauschning and Lindgren from 2.2 to 0.4, Lysholm from 54 to 86, and VAS of perceived satisfaction from 5.0 to 9.0. No persistent complications occurred. Arthroscopy revealed simple cyst morphology in 72/97 (74.2%) and presence of a valvular mechanism in all cases. The most prevalent intra-articular pathologies were medial meniscus (48.5%) and chondral lesions (33.0%). There were significantly more recurrences in grade III-IV chondral lesions (p = 0.03).
CONCLUSIONS
Arthroscopic popliteal cyst treatment had a low recurrence rate and good functional outcomes. Severe chondral lesions increase the risk of cyst recurrence.
Topics: Humans; Popliteal Cyst; Cystectomy; Treatment Outcome; Arthroscopy; Surgeons
PubMed: 36912920
DOI: 10.1007/s00264-023-05745-6 -
Arthroscopy : the Journal of... 2002This report documents the first case of a popliteal cyst in a knee with failed unicompartmental knee arthroplasty (UKA). The cyst was treated successfully with the...
This report documents the first case of a popliteal cyst in a knee with failed unicompartmental knee arthroplasty (UKA). The cyst was treated successfully with the creation of a small communication hole between the posteromedial compartment and the popliteal cyst under direct arthroscopic visualization. This was followed by the replacement of a worn polyethylene insert via a small arthrotomy. Three months later, the popliteal mass had disappeared. This case suggests that a dissecting popliteal cyst may occur after UKA as one of the signs of a malfunction. It also suggests that treatment should be directed toward the joint and not the cyst itself.
Topics: Aged; Arthroplasty, Replacement, Knee; Debridement; Female; Humans; Osteoarthritis; Popliteal Cyst; Postoperative Complications; Recurrence; Suction
PubMed: 12426547
DOI: 10.1053/jars.2002.36485 -
Orthopedics Apr 2010To our knowledge, arthroscopic removal of loose bodies from a popliteal cyst has never been reported in the medical literature. This article describes our technique for...
To our knowledge, arthroscopic removal of loose bodies from a popliteal cyst has never been reported in the medical literature. This article describes our technique for removing loose bodies from a popliteal cyst and verifies that the procedure can be performed safely and effectively.A 52-year-old man had progressively worsening right knee pain and swelling of 3 years' duration that had been treated conservatively for 6 months. On physical examination, there was boggy swelling, a palpable popliteal cyst, crepitus with range of motion, and diffuse discomfort and tenderness about the knee. Magnetic resonance imaging showed synovitis of unclear etiology. Arthroscopic intervention was performed after conservative measures failed. An accessory posteromedial portal was used to gain access into the popliteal cyst through the posterior joint capsule. An electrocautery device was used to penetrate into the cyst through the posterior capsule after identifying the correct location of the cyst by passing a needle percutaneously through the posterior aspect of the cyst into the joint. Multiple loose bodies along with a large cartilaginous mass were identified in the popliteal cyst and removed. The patient remained symptom free at 2-year follow-up.As long as the instruments are kept in view and medial to the midline of the knee joint, the neurovascular structures lateral to the cyst are safe. Keeping the shaver suction on low during debridement will avoid pulling in any unvisualized tissue. To avoid injury to the superficial saphenous vein and nerve when making the posterior portal, the surgeon should incise through skin only, then use blunt dissection and a blunt obturator to enter into the joint. Simple decompression of large popliteal cysts can be accomplished in a similar manner.
Topics: Arthroscopy; Combined Modality Therapy; Debridement; Electrocoagulation; Humans; Joint Loose Bodies; Male; Middle Aged; Popliteal Cyst; Treatment Outcome
PubMed: 20415311
DOI: 10.3928/01477447-20100225-20 -
Nepal Medical College Journal : NMCJ Dec 2006The commonest cyst to occur in the popliteal region is the popliteal cyst and over the past years it has received much clinical attention. The commonest position of the...
The commonest cyst to occur in the popliteal region is the popliteal cyst and over the past years it has received much clinical attention. The commonest position of the popliteal cyst is in the posterosuperior aspect of the medial femoral condyle. The present case report describes a rare case of popliteal cyst, which was found on the postero-superior aspect of the lateral condyle of the femur. Interestingly, there are fewer reports of popliteal cysts occurring in the postero-superior aspect of the lateral condyle. We as anatomists describe the topographical anatomy of an unusual presentation of popliteal cyst in the postero-superior aspect of the lateral popliteal region and discuss its clinical significance. Anatomical knowledge of such anomalies may be important for clinicians, orthopedic surgeons and academicians in routine clinical practice.
Topics: Adult; Cadaver; Humans; Male; Popliteal Cyst
PubMed: 17357651
DOI: No ID Found -
Orthopedics Mar 2000
Topics: Adult; Arthrography; Diagnosis, Differential; Humans; Magnetic Resonance Imaging; Male; Popliteal Cyst
PubMed: 10741374
DOI: 10.3928/0147-7447-20000301-25 -
Nuklearmedizin. Nuclear Medicine Feb 2022The existence of a popliteal Baker's cyst was regarded as a contraindication for radiosynoviorthesis of the knee joint since decades. A so-called "ventile mechanism" was...
The existence of a popliteal Baker's cyst was regarded as a contraindication for radiosynoviorthesis of the knee joint since decades. A so-called "ventile mechanism" was discussed leading to a significant concentration of the intraarticularly applied, high energy beta emitting radiopharmaceutical yttrium-90-colloid in the cyst. This cyst arises from a bursa beneath the tendon of the medial head of the gastrocnemius muscle, normally communicating with the knee joint space. Since the cyst wall is much thinner than the knee joint capsule, a radiogenic rupture of the cyst was feared, leading to severe radiogenic necroses of the surrounding soft tissue. Due to this potential hazard, knee joint ultrasound is mandatory prior to radiosynoviorthesis to check for any popliteal cysts. New studies however decline the risk of a radiogenic cyst rupture after an appropriately performed radiosynoviorthesis of the knee joint.In case of a preexistent cyst rupture, the risk of a radiogenic tissue damage remains an issue and magnetic resonance imaging (MRI) is the method of choice to exclude this potential hazard. However, MRI sometimes leads to equivocal results. Scintigraphy of the knee joint after intraarticular application of Tc-99m-nanocolloid offers the possibility to check for the integrity of the Baker's cyst in these patients to be sure that radiosynoviorthesis will not lead to a relevant extraarticular leakage with soft tissue necroses. This study describes the procedure of intracavitary distribution scintigraphy by means of representative case reports.
Topics: Humans; Knee Joint; Magnetic Resonance Imaging; Popliteal Cyst; Treatment Outcome; Ultrasonography
PubMed: 34715704
DOI: 10.1055/a-1650-9513 -
Archives of Orthopaedic and Trauma... Jul 2014The purpose of this study was to examine the arthroscopic anatomy of posteromedial capsule and magnetic resonance imaging (MRI) findings in internal derangement of the...
PURPOSE
The purpose of this study was to examine the arthroscopic anatomy of posteromedial capsule and magnetic resonance imaging (MRI) findings in internal derangement of the knee joint and to analyze the relationship between popliteal cysts and the posteromedial capsule.
METHODS
From 2011 to 2012, a prospective study included 194 knees of consecutive arthroscopic surgeries for assorted knee problems. The anatomy of the posteromedial joint capsule was evaluated arthroscopically and divided into three types by the presence of capsular fold and opening: no capsular fold and no opening (type I), capsular fold without opening (type II), capsular fold with opening (type III). The presence and size of popliteal cyst were documented by MRI.
RESULTS
Type I was observed in 160 knees (82.5 %), type II in 10 (5.1 %) and type III in 24 (12.4 %). Popliteal cysts were found in 25 knees (12.9 %) by MRI. Of these cases, symptomatic popliteal cysts were identified in 12 knees (6.9 %). On 160 knees demonstrated to be type I, only 3 knees (1.9 %) had popliteal cysts in MRI, 6 knees (60 %) in 10 knees of type II and 16 knees (66.7 %) in 24 knees of type III. Therefore, there was a statistically significant relationship between the type of anatomy in the posteromedial capsule and the popliteal cyst (p < 0.001).
CONCLUSION
An association between popliteal cyst and arthroscopic anatomy of posteromedial capsule was demonstrated. Comprehensive understanding and knowledge of the arthroscopic anatomy of posteromedial capsule would contribute to the arthroscopic approach in understanding the pathogenesis of popliteal cyst.
STUDY DESIGN
Development of diagnostic criteria on basis of consecutive patients.
LEVEL OF EVIDENCE
2.
Topics: Adolescent; Adult; Aged; Arthroscopy; Female; Humans; Imaging, Three-Dimensional; Joint Capsule; Knee Joint; Magnetic Resonance Imaging; Male; Middle Aged; Popliteal Cyst; Prospective Studies; Treatment Outcome
PubMed: 24781525
DOI: 10.1007/s00402-014-2001-0