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Zhongguo Gu Shang = China Journal of... Sep 2023To investigate efficacy between arthroscopic popliteal cyst drainage and arthroscopic popliteal cyst resection.
OBJECTIVE
To investigate efficacy between arthroscopic popliteal cyst drainage and arthroscopic popliteal cyst resection.
METHODS
From January 2013 to June 2021, 54 patients with popliteal cyst (Rausching-Lindgren gradeⅠto Ⅲ) were treated with arthroscopic surgery. There were 24 males and 30 females. The age ranged from 44 to 72 years old, with a mean of (62.67±6.08) years old. The course of the disease ranged from 1 to 72 months, with a mean of(15±14) months. Twenty-four patients (group A) were underwent arthroscopic internal drainage of popliteal cyst. Thirty patients (group B) were underwent arthroscopic resection of popliteal cyst. Preoperative main symptoms included knee pain, swelling, walking pain, popliteal swelling, popliteal mass and so on. After 1, 3, 6 months and 1, 2 years of surgery, routine outpatient follow-up was conducted to observe and compare the surgical time, bleeding volume, preoperative and postoperative visual analog scale (VAS), knee Lysholm score, and complications between two groups.
RESULTS
All incisions healed at one stage after operation. All 54 patients were followed up, and the duration ranged from 6 months to 2 years, with an average of (13.89±4.29) months. There was no intraoperative vascular or nerve injury. Operation time and intraoperative blood loss of the two groups:group A of (62.08±9.55) min and (8.00±1.69) ml, group B of (69.50±6.99) min and (8.70±2.00) ml. Popliteal pain, swelling, limitation of flexion and extension were significantly relieved after operation. VAS before and one month after operation between two groups:group A of 5.38±1.21 and 2.63±0.71, group B of 5.60±1.26 and 2.80±0.81. Lysholm scores of knee joint before and 6 months after operation:group A of 62.59±4.99 and 89.74±2.90, group B of 63.87±3.23 and 89.02±2.35. Knee joint function improved significantly in both groups. In group A, 4 cases had popliteal cyst at 3 months after operation, and 2 cases had small isolated cyst at 1 year after operation. There was no recurrence of cyst in group B.
CONCLUSION
The results between two arthroscopic treatments of popliteal cyst are satisfactory, and there is no significant difference in the amount of blood loss, safety, postoperative pain VAS score and knee function recovery. It is suggested that arthroscopic resection of the cyst wall should be performed when the technique is mature, especially for large cysts and septal cysts.
Topics: Female; Male; Humans; Adult; Middle Aged; Aged; Popliteal Cyst; Drainage; Cysts; Knee Joint; Pain
PubMed: 37735074
DOI: 10.12200/j.issn.1003-0034.2023.09.008 -
Journal of Neurosurgery. Case Lessons Sep 2023Intraneural cysts involving the tibial nerve in the knee region (popliteal fossa) are rare. According to the articular (synovial) theory, which posits a joint origin for...
BACKGROUND
Intraneural cysts involving the tibial nerve in the knee region (popliteal fossa) are rare. According to the articular (synovial) theory, which posits a joint origin for this pathology, these cysts originate from either the superior tibiofibular joint (STFJ) or the tibiofemoral (knee) joint. As tibial intraneural cysts arising from the tibiofemoral joint remain poorly understood, the authors present 2 illustrative cases and a review of the world's literature on all tibial intraneural ganglion cysts in the knee region.
OBSERVATIONS
Fourteen cases of tibial intraneural ganglion cysts arising from the tibiofemoral joint were identified in the literature. Different articular branch patterns were demonstrated, which could be explained by the varied, rich articular branch innervation at the knee. Favorable outcomes were observed in cases in which the articular branch had been disconnected and the cyst drained and were comparable to the outcomes seen in tibial intraneural ganglion cysts with an STFJ origin.
LESSONS
Tibial intraneural cysts in the knee region can be subdivided by their joint of origin: the STFJ or the tibiofemoral joint. Those arising from the tibiofemoral joint originate from different areas of the joint and propagate in predictable patterns, with favorable outcomes following surgical intervention when the joint connection is identified and treated. The origin of tibial intraneural cysts from the tibiofemoral joint are more complex than those originating from the STFJ but seem to have similar propagation patterns and outcomes.
PubMed: 37728275
DOI: 10.3171/CASE23314 -
Journal of Orthopaedic Surgery and... Sep 2023As a common disease in orthopedic clinics, popliteal cysts often coexist with intra-articular lesions. Compared with traditional open surgery, arthroscopic treatment of...
BACKGROUND
As a common disease in orthopedic clinics, popliteal cysts often coexist with intra-articular lesions. Compared with traditional open surgery, arthroscopic treatment of popliteal cysts is less traumatic, and intra-articular lesions can be treated. The 'one-way valve' mechanism of the popliteal cyst can be removed by expanding the communication between the articular cavity and the cyst to avoid cyst recurrence. In terms of arthroscopic techniques, the comparison of clinical effects between the double posteromedial portal (DPP) and single posteromedial portal (SPP) has rarely been studied. The purpose of this retrospective study was to compare the clinical effects of DPP and SPP.
METHODS
A total of 46 consecutive patients with symptomatic popliteal cysts who underwent arthroscopic treatment were included in this study and followed for approximately 1 year. All patients were divided into two groups according to the arthroscopic portals (DPP group and SPP group). The cyst size, Lysholm score and Rauschening-Lindgren (R-L) grade were evaluated before the operation for all patients, and the intra-articular lesions, operative time and complications were recorded after operation. At the last follow-up, the Lysholm score and R-L grade were recorded, and magnetic resonance imaging was used to evaluate the outcome of the cyst. The clinical data of the two groups was statistically compared and analyzed.
RESULTS
There were no significant differences in preoperative cyst size, Lysholm score or R-L grade between the two groups (P > 0.05). The operation time of the DPP group (67.52 ± 18.23 min) was longer than that of the SPP group (55.95 ± 16.40 min) (P = 0.030), but the recurrence rate of cysts in the DPP group (0%) was obviously lower than that in the SPP group (19.0%) (P = 0.046). There were no significant differences in the Lysholm score, R-L grade or complication rate between the two groups at the last follow-up (P > 0.05).
CONCLUSION
Arthroscopic treatment of popliteal cysts using double posteromedial portals was a safe and effective surgical method.
TRIAL REGISTRATION
ChiCTR, ChiCTR2200060115. Registered 19 May 2022, https://www.chictr.org.cn/showproj.html?proj=133199.
Topics: Humans; Popliteal Cyst; Retrospective Studies; Cysts; Joints; Ambulatory Care Facilities
PubMed: 37667310
DOI: 10.1186/s13018-023-04132-6 -
Journal of Orthopaedic Case Reports Aug 2023This is a case of a popliteal swelling which was clinically misdiagnosed as a simple popliteal cyst, which turned out to be a benign fibroblastic tumor featuring nodular...
INTRODUCTION
This is a case of a popliteal swelling which was clinically misdiagnosed as a simple popliteal cyst, which turned out to be a benign fibroblastic tumor featuring nodular fasciitis (NF). A swelling in the popliteal fossa by and large is considered to be a Baker's cyst. However, an array of other lesions which can be encountered such as fibroma featuring NF, meniscal cysts, lipoma, aneurysms, bursitis of the biceps femoris tendon, and schwannoma should also be borne in mind since clinical and radiological evaluation may not always be conclusive. This case report presents fibroma featuring NF masquerading as Baker's cyst, which has not been described in any literature that the authors could find hitherto, making it a unique case.
CASE REPORT
A 20-year-old male man presented to the outpatient department with a solitary palpable mass on the posterior aspect of his right knee for the past 3 years associated with difficulty in squatting for the past 3 months. The mass gradually was well defined and increased gradually in size to the current size of 10*9 cm, irregular soft to firm in consistency, spherical, non-tender, and non-reducible on the posterior aspect of the popliteal fossa. Local ultrasonography showed evidence of heterogeneous hypoechoic lesion with signs of inflammation; underlying bony cortices appeared to be normal. A clinical diagnosis of Baker's cyst was made and an excisional biopsy was performed. Microscopically, histologic sections showed fibroblasts arranged in loose fascicular patterns intermixed with small amount of collagen and myxoid stroma.
CONCLUSION
Popliteal masses need not always be simple Baker's cyst, and careful evaluation of the mass in the popliteal fossa is always mandatory. Radiologic investigations may not always be conclusive and biopsy is the gold standard for diagnosis.
PubMed: 37654746
DOI: 10.13107/jocr.2023.v13.i08.3796 -
JBJS Case Connector Jul 2023We report a case of delayed presentation of popliteal artery laceration after arthroscopic meniscectomy. Three weeks after the procedure, the patient developed severe...
CASE
We report a case of delayed presentation of popliteal artery laceration after arthroscopic meniscectomy. Three weeks after the procedure, the patient developed severe calf pain, swelling over the popliteal fossa, and foot drop, despite a normal initial postoperative period. Clinical examination and radiological investigations suggested a massive hematoma in the popliteal fossa. A decision was made to explore the popliteal artery and drain the hematoma after consultation with the vascular surgeon. A laceration was noted, and it was repaired.
CONCLUSION
Orthopaedic surgeons should maintain a high index of suspicion regarding the possibility of this postoperative complication, especially after an arthroscopic meniscectomy.
Topics: Humans; Popliteal Artery; Meniscectomy; Lacerations; Popliteal Cyst; Hematoma
PubMed: 37535768
DOI: 10.2106/JBJS.CC.23.00160 -
International Journal of Rheumatic... Nov 2023
Topics: Humans; Popliteal Cyst; Arthritis, Rheumatoid
PubMed: 37491774
DOI: 10.1111/1756-185X.14843 -
Panminerva Medica Mar 2024
Topics: Humans; Popliteal Cyst; Treatment Outcome
PubMed: 37439788
DOI: 10.23736/S0031-0808.23.04932-7 -
Clinical Pediatrics Mar 2024
Topics: Child; Humans; Popliteal Cyst; Joint Diseases; Treatment Outcome; Knee Joint
PubMed: 37208898
DOI: 10.1177/00099228231175467