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Orthopaedics & Traumatology, Surgery &... Oct 2023In previous studies, good results have been reported after arthroscopic treatment of popliteal cysts and concomitant intra-articular pathology. However, only a few...
BACKGROUND
In previous studies, good results have been reported after arthroscopic treatment of popliteal cysts and concomitant intra-articular pathology. However, only a few studies have reported the associated factors with residual popliteal cysts. The aim of this study was to examine the clinical and radiographic outcomes and investigate the factors associated with the recurrence of popliteal cyst after arthroscopic cyst decompression and cyst wall resection.
HYPOTHESIS
The authors hypothesized that residual popliteal cyst after arthroscopic decompression and cystectomy would be associated with degenerative cartilage lesions.
PATIENTS AND METHODS
From December 2010 to December 2018, 54 patients with popliteal cysts were treated with arthroscopic decompression and cyst wall resection through an additional posteromedial cystic portal. Magnetic resonance imaging (MRI) or ultrasonography was used to observe whether the popliteal cyst had disappeared or decreased. The maximum diameter of the popliteal cyst was measured after surgery. The patients were classified into the disappeared and reduced groups according to the treatment outcome. Age, sex, symptom duration, preoperative degenerative changes based on the Kellgren-Lawrence (K-L) grade, cartilage lesions according to the International Cartilage Repair Society (ICRS) grades, synovitis, functional outcomes, and associated intra-articular lesions were compared between the two groups. The functional outcome was evaluated on the basis of the Rauschning and Lindgren knee score. The study included 22 men and 32 women, with mean age of 49.6 years (range, 5-82 years). According to the ICRS grade system, 28 (51.8%) patients had grade 0 to II, 26 (48.2%) patients had grade III to IV.
RESULTS
Follow-up radiographic evaluation revealed that the cyst had completely disappeared in 20 patients (37%) and reduced in size in 34 (63%). The mean cyst size was decreased significantly from 5.7cm (range, 1.7-15cm) to 1.7cm (range, 0-6.4cm), and the Rauschning and Lindgren knee score showed improved clinical features in all the patients. Between the disappeared and reduced groups, the presence of degenerative cartilage lesions (p=0.022, odds ratio 8.702, 95% confidence interval: 1.368-55.362) showed statistically significant differences.
DISCUSSION
Through the posteromedial cystic portal, cysts were completely removed in approximately 40% of patients, and the size was reduced in 60% of patients. Presence of degenerative cartilage lesion represents an associated risk factor for residual popliteal cyst. These findings could be helpful in ensuring explaining poor prognostic factors.
LEVEL OF EVIDENCE
IIIb; retrospective cohort study.
Topics: Male; Humans; Female; Middle Aged; Popliteal Cyst; Cystectomy; Retrospective Studies; Arthroscopy; Treatment Outcome; Risk Factors; Decompression
PubMed: 36921759
DOI: 10.1016/j.otsr.2023.103595 -
Skeletal Radiology Nov 2023The cause of knee osteoarthritis (OA) and knee pain associated with OA is not well understood. Periarticular cystic lesions and bursae around the knee are among the most... (Review)
Review
The cause of knee osteoarthritis (OA) and knee pain associated with OA is not well understood. Periarticular cystic lesions and bursae around the knee are among the most common morphologic features identified on MRI in the setting of OA. Despite widespread association of these lesions with knee OA and their inclusion in semiquantitative MRI scoring assessment systems for knee OA, the role that these lesions play in the development of knee pain and OA remains uncertain. In this discussion, we review the cystic lesions and bursae most commonly associated with OA of the knee, examine their relation and role in whole organ imaging assessments of OA, and present the literature investigating the associations of periarticular cysts and cyst-like lesions with knee pain and OA.
Topics: Humans; Osteoarthritis, Knee; Knee Joint; Knee; Bursa, Synovial; Magnetic Resonance Imaging; Pain
PubMed: 36764945
DOI: 10.1007/s00256-023-04295-7 -
Journal of Orthopaedic Science :... Jan 2024
Topics: Humans; Popliteal Cyst
PubMed: 35487800
DOI: 10.1016/j.jos.2022.04.005