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BMC Musculoskeletal Disorders Jul 2020This study aimed to compare the arthroscopic internal drainage of popliteal cysts alone or in combination with cyst wall resection in terms of clinical outcomes.
BACKGROUND
This study aimed to compare the arthroscopic internal drainage of popliteal cysts alone or in combination with cyst wall resection in terms of clinical outcomes.
METHODS
Forty-two consecutive patients with symptomatic popliteal cysts received arthroscopic treatment. Specifically, 20 of them received arthroscopic internal drainage (AI group) alone and 22 received arthroscopic internal drainage combined with cyst wall resection (AICR group) through double posteromedial portals. Magnetic resonance imaging (MRI) was performed to identify recurrence of popliteal cysts. The Lysholm score and Rauschning-Lindgren grade were used to assess the clinical outcomes. The median of the follow-up period was 24 months (12-48 months).
RESULTS
The two groups (AI group and AICR group) were similar in age, gender, cyst diameter, associated joint disorder, preoperative Lysholm score, preoperative Rauschning-Lindgren grade and follow-up period (P > 0.05). Relative to the AI group, the AICR group had a significantly prolonged operation time (P < 0.05) and a higher incidence of complications (P < 0.05). In both groups, the Rauschning-Lindgren grade at the last follow-up significantly differed from the preoperative grade (P < 0.05) and the Lysholm knee score remarkably increased compared to the preoperative score (P < 0.05); however, there were no differences between the two groups at the last follow-up (P > 0.05). According to the MRI results, the cyst disappeared in 11 (55%), shrank in size in 6 (30%) and existed in 3 (15%) patients in the AI group, and was absent in 18 (81.8%) and shrank in size in 4 (18.2%) patients in the AICR group, suggesting a significant difference between the two (P < 0.05).
CONCLUSION
Additional resection of cyst wall can result in a lower recurrence rate of cysts but extend the operation time and increase the incidence of perioperative complications compared with arthroscopic internal drainage of popliteal cysts alone.
Topics: Adult; Arthroscopy; China; Drainage; Female; Humans; Knee Joint; Magnetic Resonance Imaging; Male; Middle Aged; Neoplasm Recurrence, Local; Operative Time; Popliteal Cyst; Postoperative Complications; Severity of Illness Index; Treatment Outcome
PubMed: 32631287
DOI: 10.1186/s12891-020-03453-5 -
Vascular Specialist International Jun 2020Adventitial cystic disease (ACD) is a very rare condition characterized by the accumulation of a cyst filled with gelatinous substance in the adventitia of a vessel... (Review)
Review
Adventitial cystic disease (ACD) is a very rare condition characterized by the accumulation of a cyst filled with gelatinous substance in the adventitia of a vessel adjacent to the joint area. The cyst usually compresses the vessel lumen, causing claudication or leg swelling. The disease usually affects the popliteal artery. However, several cases of venous ACDs particularly in the common femoral or external iliac vein have been reported. The definition, diagnosis, and optimal treatment of ACD remain controversial because of its rarity and the inconsistent use of terminology. The heterogeneity of the reported cases is more prominent in venous ACD. Herein, the accurate terminology of cysts correlated to the joint (synovial cyst, ganglion cyst, and adventitial cyst) and the pathogenesis, anatomy, and optimal therapy of venous ACD are discussed in detail to establish reporting standards for future studies.
PubMed: 32611837
DOI: 10.5758/vsi.200029 -
Medicine May 2020There is a lack of research comparing the clinical effects of arthroscopic treatment of popliteal cysts between the one posteromedial portal (OPP) technique and the two... (Comparative Study)
Comparative Study Observational Study
There is a lack of research comparing the clinical effects of arthroscopic treatment of popliteal cysts between the one posteromedial portal (OPP) technique and the two posteromedial portals (TPP) technique. The aim of this study was to evaluate and compare the clinical efficacy of arthroscopic treatment for popliteal cysts between the 2 techniques.Patients with symptomatic popliteal cysts after surgery were retrospectively invited to participate in this study. They received arthroscopy treatment via the OPP technique or the TPP technique. At the final follow-up, the Rauschning and Lindgren criteria and the Lysholm score were used for clinical evaluation. Moreover, magnetic resonance imaging was performed to detect the recurrence of cysts postoperatively.Finally, 53 patients with symptomatic popliteal cysts were included in this study, including 25 in the OPP group and 28 in the TPP group. The operation time of the TPP group was significantly longer than that of the OPP group (P < .001). In the OPP group, the cysts disappeared in 17 patients and reduced in size in 8 patients. In the TPP group, the cysts disappeared in 23 patients and reduced in size in 5 patients. According to the Rauschning and Lindgren classification, the recurrence rate was significantly lower in the TPP group (0%) than in the OPP group (4%) (P = .03). In addition, there was no significant difference in the Lysholm score between the OPP group and the TPP group (P = .77).TPP technique is more effective and superior than OPP technique for the treatment of popliteal cysts.
Topics: Arthroscopy; Female; Humans; Male; Middle Aged; Popliteal Cyst; Retrospective Studies
PubMed: 32443304
DOI: 10.1097/MD.0000000000020020 -
The Journal of Spinal Cord Medicine Mar 2022Deep vein thrombosis (DVT) is a well-known complication of spinal cord injury (SCI). Low-molecular-weight heparin (LMWH) may be used in SCI patients who develop DVT,...
Deep vein thrombosis (DVT) is a well-known complication of spinal cord injury (SCI). Low-molecular-weight heparin (LMWH) may be used in SCI patients who develop DVT, but can lead to subcutaneous bleeding. If subcutaneous bleeding occurs, then lymphedema, cellulitis, muscle or tendon tearing, or baker's cyst rupture should be considered in the differential diagnosis. Herein, we present a 61-year-old female patient who was hospitalized for rehabilitation due to paraplegia, and used LMWH due to DVT development. The patient suddenly developed pain, swelling, and discoloration of the left lower extremity. Although subcutaneous hemorrhage was considered initially, ultrasound and MRI revealed a ruptured Baker's cyst. In addition to supportive therapy, ultrasound-guided aspiration was performed. In this report, we present a case of clinically severe Baker's cyst rupture, which occurred in the lower extremity of a SCI patient using LMWH due to DVT in the same extremity. To our knowledge, no similar cases have been reported.
Topics: Female; Heparin, Low-Molecular-Weight; Humans; Middle Aged; Popliteal Cyst; Spinal Cord Injuries; Ultrasonography; Venous Thrombosis
PubMed: 32379533
DOI: 10.1080/10790268.2020.1754652 -
BMC Musculoskeletal Disorders Feb 2020In adults, Baker's cyst development is attributable principally to secondary alterations after degenerative changes. The latter changes often accompany osteoarthritis,...
BACKGROUND
In adults, Baker's cyst development is attributable principally to secondary alterations after degenerative changes. The latter changes often accompany osteoarthritis, and we frequently encounter patients with Baker's cysts seeking total knee arthroplasty (TKA). Baker's cysts are not usually subject to extensive preoperative evaluation because the cysts often disappear naturally after surgery, unaccompanied by any adverse symptoms.
CASE PRESENTATION
A 63-year-old woman presented with moderate pain in the left knee joint that had developed 1 year ago. Posterior knee pain was aggravated on maximum knee flexion. Three months previously, a popliteal mass had become palpable and the patient had undergone needle mass aspiration twice in a local orthopedic hospital, but the mass had recurred. We initially considered TKA for her severe degenerative osteoarthritis. However, we decided to perform only arthroscopic debridement and cyst excision because the patient was experienced severe pain only on maximal knee flexion, and did not want TKA. Pus gushed from the torn cyst during the operation. We diagnosed an infected Baker's cyst. The patient was treated with a first-generation cephalosporin postoperatively.
CONCLUSIONS
A Baker's cyst that was aspirated and still causes symptoms with altered blood tests needs to be evaluated accurately before TKA.
Topics: Arthralgia; Arthroplasty, Replacement, Knee; Arthroscopy; Cephalosporins; Debridement; Female; Humans; Knee Joint; Magnetic Resonance Imaging; Middle Aged; Osteoarthritis, Knee; Pain Measurement; Popliteal Cyst; Preoperative Care; Prosthesis-Related Infections; Risk Factors; Severity of Illness Index; Treatment Outcome
PubMed: 32113464
DOI: 10.1186/s12891-020-3147-2 -
Journal of Rural Medicine : JRM Jan 2020Cystic adventitial disease (CAD), a rare arterial disorder, can cause localized arterial stenosis or obstruction. A 55-year-old man presented with a 2-month history of...
Cystic adventitial disease (CAD), a rare arterial disorder, can cause localized arterial stenosis or obstruction. A 55-year-old man presented with a 2-month history of left lower leg pain and paleness when bending the left knee. The patient was diagnosed with CAD of the left popliteal artery based on imaging examinations. Surgery was performed with the patient placed in the prone position using an S-shaped skin incision, and the left popliteal artery was exposed. A simple incision of the cyst wall was made. There was no sign of recurrence at 1 year postoperatively.
PubMed: 32015782
DOI: 10.2185/jrm.2019-010 -
Case Reports in Medicine 2020When evaluating a patient with acute onset unilateral leg pain and concurrent inflammatory bowel disease (IBD), keeping a broad differential diagnosis will allow for...
When evaluating a patient with acute onset unilateral leg pain and concurrent inflammatory bowel disease (IBD), keeping a broad differential diagnosis will allow for prompt diagnosis and management. The patient described in this case report is a 32-year-old male with inflammatory ileocolonic Crohn's disease (CD) status after ileocecectomy with perianal involvement and known Type 1 arthropathy. He presented with a three-day history of unilateral leg swelling and tenderness. Initial evaluation focused on possible thrombosis given the development of erythema and systemic symptoms. Final diagnosis was ruptured Baker's (popliteal) cyst. This pathology is not well described in existing literature, but should be considered in IBD patients given their chronic inflammatory state and common associated intra-articular pathology.
PubMed: 31975994
DOI: 10.1155/2020/3149058 -
Annals of Vascular Diseases Dec 2019Adventitial cystic disease of the popliteal artery is a rare non-atheromatous peripheral artery disease. In most cases, the cystic lesion is located in the adventitia of...
Adventitial cystic disease of the popliteal artery is a rare non-atheromatous peripheral artery disease. In most cases, the cystic lesion is located in the adventitia of the popliteal artery. Herein, we present a rare case of cystic arterial disease in which the cyst was located only in the media of the popliteal artery. We successfully treated the cyst with resection of the affected popliteal artery and reconstruction with an autogenous vein graft.
PubMed: 31942213
DOI: 10.3400/avd.cr.19-00057 -
Nuclear Medicine and Molecular Imaging Oct 2019The authors present two cases in which the ruptured popliteal (Baker's) cysts remained undetected and were diagnosed only during an isotope investigation. The aim was to...
The authors present two cases in which the ruptured popliteal (Baker's) cysts remained undetected and were diagnosed only during an isotope investigation. The aim was to describe a specific imaging sign, the "arch sign", that is indicative of ruptured Baker's cysts. In both cases, the whole-body imaging was performed 2 hours after injection of 706.7 MBq of Tc-99m-MDP. Single-photon emission computed tomography (SPECT) imaging was performed to localize an accumulation of the radiopharmaceutical. An analysis of literature was performed to connect these cases with previously reported data and to detect the pathognomonic radio image sign of ruptured popliteal cysts. The arch-shaped distribution of the radiopharmaceutical below the knee joints was seen already on the whole-body bone scan image in both cases. An anterior view of SPECT MIP images showed the arched accumulation of the Tc-99m-MDP bone tracer along the postero-medial aspect of the right calf secondary to synovial fluid leak from a ruptured Baker's cyst. The similar arthroscintigrams were published since 1971 without recognizing this sign as pathognomonic. Tc-99m-MDP bone scanning is sensitive for a Baker's cyst with synovial effusion, and distribution of a radiopharmaceutical in the medial posterior calf in a shape of an arch, the arch sign, may serve as an indicator of a ruptured popliteal cyst.
PubMed: 31723365
DOI: 10.1007/s13139-019-00605-x -
The Korean Journal of Internal Medicine Sep 2020
Topics: Arthritis, Rheumatoid; Communication; Humans; Iatrogenic Disease; Knee Joint; Popliteal Cyst
PubMed: 31422651
DOI: 10.3904/kjim.2019.202