Abstract
BackgroundAssociated joint disorders with popliteal cysts were stated approximately between the ranges of 41–83 % in all reported cases. Combined treatment strategies that eliminate intra-articular pathologies and cyst- associated valve mechanisms are thought to be a good option in treatment of the disease. In this study, our main objective is to present clinical results of our combined treatment results, which includes posterior cyst excision with supine arthroscopic intervention, targeting intra-articular pathologies on recalcitrant cases.MethodsOne hundred three knees of 100 patients treated with posterior open cystectomy with valve and repair of posterior capsule, in addition to arthroscopic treatment of intra-articular lesions, were included in the study. Preoperative magnetic resonance imaging (MRI) studies were performed in order to evaluate location of Baker cysts behind the knee. Rauschning-Lindgren and Lysholm Knee Scoring Scales were used to assess pre/post-operative knee functions.Mann-Whitney U test was used to evaluate the differences between genders in comparison of Lysholm and Lindgren scores. Mean age within gender groups was compared using independent samples t-test. Wilcoxon test was used to compare the change in Lysholm and Lindgren scores. A p-value of less than 0.05 was considered to show a statistically significant result.Over the 1-year follow-up period, US and MR imaging was performed only with symptomatic patients.ResultsCyst recurrence was seen only in 2 (1.94 %) patients. Post-operative Lysholm Knee and Lindgren knee scores demonstrated improvement in knee function and general comfort level of the patients.ConclusionsOur midterm follow-up (Mean: 39 Months) results showed that open cyst excision with valve and capsule repair with knee arthroscopy that targets associated intra-articular pathologies reduced the pain and improved the knee function in those patients.Level of evidenceIV (Retrospective clinical study without comparison group).
Highlights
Associated joint disorders with popliteal cysts were stated approximately between the ranges of 41–83 % in all reported cases
In their arthroscopic study of the anatomy of the knee joint, Kim et al further confirmed a relationship between the presence of a capsular fold in the posteromedial capsule and the popliteal cyst [11]
We demonstrated that open posterior cystectomy, performed in combination with arthroscopic treatment of intra-articular pathologies of the knee, reduced pain, and improved symptoms and knee function
Summary
Associated joint disorders with popliteal cysts were stated approximately between the ranges of 41–83 % in all reported cases. Baker clarified that the communication between the cyst and the joint synovium behaves as a one-way valve, with fluid leaking into the bursa but with no possible flow in the reverse direction. As part of his description, Baker described the possibility of a ruptured bursa, which resembled a venous thrombosis. The study by Rauschning and Lindgren provided a detailed description of the association between this valve mechanism and flexion and extension movements of the knee [9, 10] In their arthroscopic study of the anatomy of the knee joint, Kim et al further confirmed a relationship between the presence of a capsular fold in the posteromedial capsule and the popliteal cyst [11]. Overall, associated joint disorders with popliteal cysts were reported approximately between the ranges of 41–83 % in all reported cases [12,13,14,15,16,17]
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