Abstract
PurposeParameniscal cysts are associate with horizontal meniscal tears. Arthroscopic meniscal repair and the excision of the cyst by mini-open approach represent a valid treatment. However, the recurrence of cyst is still a current issue. Therefore, biological factors may be considered to promote the biological repair and avoid recurrence. The aim of the present study was to report the clinical results and the rate of recurrence of the cyst after minimum 2-year of follow up in a cohort of patients treated by meniscal repair and autologous platelet-rich fibrin matrix augment.MethodsPatients with lateral parameniscal cyst undergoing arthroscopic meniscal repair and autologous platelet-rich fibrin matrix augment between 2016 and 2019 were retrospectively reviewed in March 2021. Inclusion criteria were absence of prior surgery on the affected knee with minimum 2-year of follow-up. Exclusion criteria were concomitant ligament lesions, rheumatic diseases and knee osteoarthritis. After reviewing the database, each selected patient was contacted and asked to participate in the study; at the follow-up evaluation all patient signed an informed consent. Tegner-Lysholm knee score, IKDC and NRS were collected before surgery and at follow-up.ResultsThis study included 15 patients (8 male) with mean age of 32.8 years old. No recurrence of the cysts was observed. The Tegner-Lysholm knee score and IKDC subjective scores increased respectively from 41.3 ± 5.4 and 37.6 ± 5.1 at baseline to 92.3 ± 4.6 and 89.4 ± 2.6 at the final follow up. Concerning pain relief, the Numeric Pain Rating Scale (NRS) displayed a significant improvement reaching at the follow up a score of 1,3 ± 1.1 in comparison to 6.8 ± 0.9 at the baseline.ConclusionSurgical management of symptomatic lateral parameniscal cyst with cyst excision, autologous PRP membrane application and meniscus repair demonstrated excellent subjective clinical outcome with any cyst reoccurrence.Level of evidenceIII, retrospective cohort study.
Highlights
Parameniscal cysts are defined as internal disorder of the knee joint located on the medial or on the lateral side that might be asymptomatic or cause knee pain, joint swelling and soft tissue masses [1]
Concerning pain relief, the Numeric Pain Rating Scale (NRS) displayed a significant improvement reaching at the follow up a score of 1,3 ± 1.1 in comparison to 6.8 ± 0.9 at the baseline
Two arthroscopic techniques have been widely used for the treatment of parameniscal cysts: arthroscopic and mini-open excision which aim to remove the entire cyst by a mini-open approach after arthroscopic meniscal repair, and an entirely arthroscopic procedures consisted by meniscectomy and cyst decompression [4]
Summary
Parameniscal cysts are defined as internal disorder of the knee joint located on the medial or on the lateral side that might be asymptomatic or cause knee pain, joint swelling and soft tissue masses [1]. Most of the orthopedic literature focused on the cysts located on the lateral side because they were usually symptomatic [2, 3]. In symptomatic patients the surgical treatment is mandatory. Two arthroscopic techniques have been widely used for the treatment of parameniscal cysts: arthroscopic and mini-open excision which aim to remove the entire cyst by a mini-open approach after arthroscopic meniscal repair, and an entirely arthroscopic procedures consisted by meniscectomy and cyst decompression [4]. In case of large cyst, subtotal meniscectomies might be necessary to carry out the decompression [5], the combined arthroscopic and mini-open approach may be preferred especially in young patients
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