Parameniscal Cysts: Is Formal Cyst Decompression Necessary? (SS-31)

Abstract

Introduction Parameniscal cysts are typically managed by open excision or arthroscopic decompression with concomitant partial meniscectomy. The purpose of this study was to compare a series of patients with parameniscal cysts and associated meniscal tears that were treated with arthroscopic partial meniscectomy and cyst decompression to a series of patients that were treated by arthroscopic partial meniscectomy alone. We hypothesize that patients can be managed with partial meniscectomy alone and achieve a successful clinical outcome. Methods This is a retrospective case controlled study of 25 consecutive patients with a meniscal cyst treated by the senior author between 2003 and 2008. Inclusion criteria were an isolated meniscal tear and parameniscal cyst demonstrated on MRI, no prior knee surgery, and an Outerbridge classification of I/II. Group 1 patients were treated with partial meniscectomy and cyst decompression; Group 2 was treated with partial meniscectomy alone. Variables recorded included age, mechanism of injury, sport/occupation, primary complaint, duration of symptoms, and physical findings. Outcome scores were obtained using the Lysholm knee score. Results Twenty-three patients met the inclusion criteria for this study. There were no significant differences in the demographics between the two groups. The Lysholm knee score was 97.8 with partial meniscectomy and formal cyst decompression, and 93.9 for partial meniscectomy alone. The difference between the two means (3.9) was less than the minimal clinically important difference as described by Briggs et al. Conclusion Our results suggest that formal meniscal cyst decompression is unnecessary. Excellent clinical outcomes can be achieved by treating parameniscal cysts with partial meniscectomy alone and no formal cyst decompression.