Abstract
BackgroundThis systematic review and meta-analysis of the clinical efficacy of different surgical methods in the therapy of popliteal cysts may provide evidence about effective surgical treatments.MethodsPubMed, EMBASE, and OVID were searched with the following terms: (popliteal cyst* OR baker’s cyst*) AND (arthroscopic OR excision OR operative OR treat* OR surgery). Inclusion criteria included the following: studies reported the efficacy of different surgical methods in popliteal cyst patients; patients were ≥16 years; and studies must have involved a minimum of 10 patients. Studies were grouped according to the surgical methods, and a meta-analysis was employed to identify the success rate based on the pooled data.ResultsA total of 11 studies were included: The communication between the cyst and the articular cavity was enlarged in 7 studies; this communication was closed in 3 studies; and only intra-articular lesions were managed in 1 study. After the data were pooled, the success rates were 96.7 and 84.6 % in the communication-enlargement group and communication-closure group, respectively. Studies with communication enlargement were subgrouped into the cyst wall resection group and the non-cyst wall resection group, for which the success rates were 98.2 and 94.7 %, respectively.ConclusionsBased on the current available evidence, at present, any how arthroscopic excision of the cyst wall, arthroscopic management of intra-articular lesions, and enlarging the communication between the cyst and the articular cavity is an ideal strategy for the popliteal cyst. The current literature on the treatment of popliteal cysts is limited to retrospective case series. Future prospective studies with high-quality methodology and uniform scoring system are required to directly compare communication-enlargement surgery and communication-closure surgery and determine the optimal treatment of popliteal cysts. Cyst wall resection may improve the therapeutic efficacy, to draw definitive conclusions, and high-level clinical researches with a large number of patients and long-term follow-up should be initiated.
Highlights
This systematic review and meta-analysis of the clinical efficacy of different surgical methods in the therapy of popliteal cysts may provide evidence about effective surgical treatments
Among the seven studies with communication enlargement, cyst wall resection was performed in four studies, and the cyst wall was left intact in three studies
The number of studies included was small, the tools used for postoperative evaluation were inconsistent, and the measures taken to manage the intra-articular lesions were different; the influence of cyst wall resection on the success rate was not further evaluated even though two studies reported cyst resection
Summary
This systematic review and meta-analysis of the clinical efficacy of different surgical methods in the therapy of popliteal cysts may provide evidence about effective surgical treatments. Popliteal cysts are a common disease in orthopedics and the most prevalent cystic lesions around the knee joint [1]. They were first recognized by Adama in 1840, and Baker described them in detail in 1877. Popliteal cysts most commonly form by distention of the gastrocnemio-semimembranosus bursa, which is located in the medial aspect of the popliteal fossa. Asymptomatic popliteal cysts incidentally detected do not require treatment, large cysts may cause popliteal pain or disturbance in the knee range of motion, and they can be the targets of surgical intervention
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