Popliteal Cyst Research Articles

Clinical prospective comparative study on short-term effectiveness of arthroscopic treatment of popliteal cyst between cyctectomy and internal drainage combined with cyctectomy

To compare the short-term effectiveness between arthroscopic cystectomy and internal drainage combined with cystectomy in popliteal cyst. Between March 2014 and March 2017, 56 patients with symptomatic popliteal cyst were enrolled in the study, randomized block design was used to divided the patients into trial group (arthroscopic cystectomy combined with internal drainage group, n=28) and control group (arthroscopic internal drainage group, n=28). Excluding those who had incomplete follow-up and received surgery for other diseases postoperatively, 26 patients in the experimental group and 27 patients in the control group were finally enrolled in the study. There was no significant difference in gender, age, side, course of disease, maximum diameter and grade of popliteal cyst, and associated diseases between two groups ( P>0.05). The operation time, duration of popliteal ecchymosis and the middle back of calf tenderness were observed postoperatively. The circumference of calf at 1 day, 1 week, and 2 weeks after operation were measured and the differences were calculated with the measurement before operation. Lower extremity venous thrombosis was observed by color doppler ultrasonography at 1 week after operation. The effectiveness was evaluated by Rauschning and Lindgren grading criteria. And MRI was used to observe whether the popliteal cyst disappeared or decreased and measured its maximum diameter at 1 year after operation. Patients in both groups were followed up 12-14 months, with an average of 12.5 months. The operation time, duration of popliteal ecchymosis, and the middle back of calf tenderness of the trial group were all longer than those in the control group ( P<0.05), the differences of circumference of calf at 1 day, 1 week, and 2 weeks after operation of the trial group were greater than those in the control group ( P<0.05). Color doppler ultrasonography of the lower extremity at 1 week after operation found that the intermuscular venous thrombosis occurred in 2 cases of the trial group, while no lower extremity thrombosis was found in the control group; and the difference between two groups was not significant ( P=0.236). According to the Rauschning and Lindgren grading criteria, there were 16 cases of grade 0, 6 cases of grade 1, and 4 cases of grade 2 in the trial group, and 17 cases of grade 0, 4 cases of grade 1, and 6 cases of grade 2 in the control group at 1 year after operation. There was no significant difference between 2 groups ( Z=-1.872, P=0.078). Nine cases (34.62%) of the trial group and 13 cases (48.15%) of the control group still have residual cysts by MRI, the maximum diameter of which was less than 2 cm. The cysts disappeared in the remaining patients in both groups, and there was no recurrence during the follow-up. There was no significant difference in cyst residual rate between 2 groups ( χ2=2.293, P=0.852). Compared with arthroscopic internal drainage, the short-term effectiveness of the arthroscopic internal drainage combined with cystectomy had no significant improvement, and the operation time was prolonged, the postoperative complications were obviously increased.

Arthroscopic Treatment of Popliteal Cysts

Popliteal cysts, often referred to as Baker's cysts, are a common occurrence in the adult knee. Although controversy exists as to the exact indications for treatment, these structures can cause extreme discomfort and morbidity, including pain from rupture and symptoms from neurovascular compromise. Prior to the development of the arthroscope, open treatment of popliteal cysts was not uncommon. Complications such as poor wound healing, cyst recurrence, and knee flexion contractures were reported after such treatment. Owing to the presence of a valve-type structure, also called the posterior transverse synovial infold, there is 1-way flow of synovial fluid into the cyst. Although seldom described, there is a reproducible and relatively straightforward arthroscopic treatment for this pathology. This technical report will describe the arthroscopic treatment of popliteal cysts and clarify the posterior knee anatomy that gives the surgeon the landmarks to perform safe and effective arthroscopic treatment of popliteal cysts.

An Anteriorly Presenting 'Wrap Around' Popliteal Cyst.

The article describes a case in which a popliteal cyst was identified presenting as a mass on the anterior aspect of theright tibia. This occurred as a result of polyethylene wear debris from previous total knee arthroplasty. Although alternativediagnoses for an anterior tibial mass are more likely, a popliteal cyst must be considered, particularly if the patient has ahistory of total knee arthroplasty.

Arthroscopic treatment of popliteal cyst using a figure-of-four position and double posteromedial portals.

The purpose of this study was to introduce a modified arthroscopic treatment technique for popliteal cyst and hypothesize that this modified technique would provide good clinical efficacy and low recurrence rate. From January 2013 to January 2017, 34 patients with symptomatic popliteal cysts were treated with our technique. A figure-of-four position and double posteromedial portals were used to achieve adequate enlargement of the posteromedial valvular opening between the cyst and the joint cavity and complete excision of the cyst wall. MRI was used to detect the recurrence of the popliteal cyst, and the Rauschning and Lindgren score was recorded to evaluate the clinical outcome. All patients were followed up with a mean period of 14.8months (range, 12 to 36months). Associated intra-articular lesions were found and treated in all cases. Degenerative cartilage damage was the most common pathology, which affected 23 (67.6%) of the cases. The Rauschning and Lindgren score improved significantly after surgery, and no evidence of recurrence was found from MRI in any case. Our modified arthroscopic treatment technique, using a figure-of-four position and double posteromedial portals, is effective and safe for treating popliteal cyst.

Age-Related, Ultrasound and Histomorphological Features of Baker's Cyst

The aim of the study was to reveal the features of the morphological structure and ultrasonic signs of Baker's cyst in patients of different ages. Material and methods. The study is based on a sonographic study of 213 patients (mean age 57.2±9.9 years) and 10 children aged 6 to 10 years with a detected Baker cyst. The size of the cyst was studied, its position, relationship with surrounding tissues was examined on sonographic equipment. In addition, parameters were measured, including the thickness of the synovium, the presence of septa and echo-inclusions, the degree of echogenicity of the contents of the cyst. All patients underwent open extirpation of the cyst followed by its morphological analysis. All manipulations were carried out after signing the informed consent of the patient or his legal representatives according to the recommendations "About legal, legislative and ethical norms and requirements in the performance of scientific morphological studies". Preparation of the histological material obtained after the removal of Baker's cyst was carried out according to standard procedures, followed by staining with hemothoxylin-eosin and Van Guzon. The obtained preparations were examined under a light microscope with the possibility of displaying an image on a computer monitor Results. In all adults with an identified Baker cyst, gonarthrosis of varying severity was detected, in contrast to children who had no such joint pathology. Morphological differences in the transformation of the tissues of education in different age groups were also significant. The difference was noted in the form of unexpressed dystrophy of the synovial membrane and the absence of necrotic and degenerative changes in the wall of the cyst in children. Conclusions. This work demonstrated several significant ultrasound and morphological differences in the popliteal cyst in children and adults.

Arthroscopic treatment of popliteal cyst using a figure-of-four position and double posteromedial portals

Arthroscopic treatment of popliteal cyst using a figure-of-four position and double posteromedial portals

Determination of the effective mode of laser radiation for coagulation of the wall of the Baker cyst in the ex-vivo experiment.

Relevance. The Baker's cyst is the most numerous group of benign neoplasms of the popliteal region. The anatomical feature of the location, the vagueness of the etiology and pathogenesis leads to the lack of a single point of view on the tactics of treating popliteal cysts. In modern medical technologies, the method of local laser hyperthermia is often used, when the denaturing of collagen forming the basis of a tissue or an organ is based on surgical treatment. Since this technique does not have direct thermal control over the course of manipulation, it becomes necessary to strictly dosage controlled photocoagulation.&#x0D; Objectives of the study: to determine the optimal energy and time parameters of direct contact laser action on the wall of the Baker cyst in the simulation of its exo-vivo photocoagulation.&#x0D; Materials and methods of research. In the experiment we used a wall sample of Baker's cyst, obtained as a result of open extirpation of the cyst. The material was divided into 5 roughly equal in size and mass fragments. The first of them, without any physical effects, was immediately placed in a 10% formalin solution. For all other parts of the preparation, laser irradiation was carried out in a stationary manner with a surface contact of the optical fiber with the synovial layer of the samples. The effect on the fragment was carried out in a constant mode of the light flux with a wavelength of 1.47 μm.&#x0D; Results. The macroscopic and microscopic transformations that occur in the tissues of the wall of the Baker cyst were studied, with an output power of 5 and 10 W. Two series of experiments were conducted lasting 5 and 10 seconds.&#x0D; On the surface of the synovial membrane of the wall of Baker's cyst, the effect in the form of point carbonation was observed in all samples subjected to laser treatment. When a microscopic study of a drug not exposed to laser radiation, the synovial membrane was only loosened. In the fragment subjected to the contact action of 10 W laser radiation for 10 seconds, the focus of necrosis of the synovium and surface layers of collagen structures without a perifocal cell reaction is histologically determined. In all other samples, after laser photocoagulation, a focal destruction of the synovial membrane with a pronounced interstitial edema was determined in the histological study. Focal fragmentation of the surface fibers was detected near the loose loose collagen layers.&#x0D; Conclusions.The effect of high-energy laser radiation of 1.47 μm on the wall of the Baker cyst in all series of experiments did not lead to its total coagulation necrosis even in the direct irradiation zone. Considering the duration of the cyst of the energy exposure of the irradiation sufficient for the destruction of the wall, and also the small area of exposure of the laser irradiation to the face lightguide, it is evident that a considerable amount of time will be required for complete coagulation of the formation.&#x0D;

Knee Pain - Exercise

HISTORY: A 58-year-old male presented with a 4-week history of spontaneous knee pain. One year prior to presentation, he had bariatric surgery and increased his exercise regimen resulting in a 100 lb weight loss. He denies trauma or inciting injury. His pain localized to the posterolateral knee and is described as a 5/10 cramping pain. He describes a popping sensation and experiences a snapping moment in the lateral knee with deep squatting. He denies swelling and ecchymosis. He has tried ice, physical therapy and ibuprofen without relief. PHYSICAL EXAMINATION: Focused left knee exam revealed a palpable cystic structure in the lateral popliteal fossa. There is tenderness over the lateral joint line with no instability of the proximal tibiofibular joint or biceps femoris tendon. Range of motion was 0-140° with pain greater than 120° of flexion. When the knee is brought into deep flexion, there is an audible pop over the lateral aspect of the knee. When the knee is then brought into extension, there is reproduction of an audible pop and snapping moment of the lateral knee at end range extension. Flexion McMurray’s test is positive. Strength, reflexes, sensation, and pulses are normal throughout. DIFFERENTIAL DIAGNOSIS: 1. Snapping biceps femoris tendon 2. Snapping popliteus tendon 3. Lateral meniscus tear 4. Iliotibial band friction syndrome 5. Proximal tibiofibular joint instability TEST AND RESULTS: Three view x-rays of left knee: • Medial joint space narrowing. No acute fracture. Dynamic ultrasound of the left knee: • Normal biceps femoris tendon. Popliteal cyst noted. MRI of left knee without contrast: – Incomplete discoid lateral meniscus and small multiseptated popliteal cyst noted. FINAL WORKING DIAGNOSIS: Left knee discoid lateral meniscus with subluxation of the meniscus TREATMENT AND OUTCOMES: 1. Patient counseled on activity modification. 2. Dynamic ultrasound revealed no evidence of hamstring irregularities. 3. Unsuccessful ultrasound-guided aspiration of popliteal cyst attempted followed by an intra-articular corticosteroid injection. 4. After MRI evaluation, orthopedic surgery performed an arthroscopic partial meniscectomy of subluxing torn posterior horn and midbody saucerization of lateral meniscus. 5. He tolerated surgery well with no further subluxation of his meniscus in physical therapy.

Clinical outcome of arthroscopic management of popliteal cysts with or without additional posterior open cystectomy.

The aim of this retrospective study was to compare the clinical outcomes of arthroscopic decompression of popliteal cysts and simultaneous management of intra-articular pathologies alone or in combination with posterior open cystectomy. This study included 65consecutive patients with the diagnosis of popliteal cysts. Of the patients 31received arthroscopy alone (arthroscopic decompression of cysts and management of intra-articular pathologies, AA group) and 34received arthroscopy combined with open cystectomy (AO group). At the last follow-up after amean of 33.3months, magnetic resonance imaging (MRI) scans were performed to assess the outcomes of cysts and functional scores. The Lysholm score and Rauschning and Lindgren grade were used for clinical evaluation. The procedure in the AA group took less time to perform and resulted in less postoperative complications in the perioperative period. At the last follow-up, no significant differences were observed between the groups in terms of the Lysholm score or Rauschning and Lindgren grade (P > 0.05). The results of MRI showed that the cysts disappeared in 17(55%) patients, reduced in 9(29%) patients and persisted in 5(16%) patients in the AA group, and disappeared in 29(85%) patients, reduced in 4(12%) patients and persisted in 1(3%) patients in the AO group, which was significantly different (P < 0.05). In the AA group 6patients and 1in the AO group were grade2 or3 and needed asecond operation (arthroscopy combined with open cystectomy), which was significantly different (P < 0.05). In comparison to arthroscopic decompression of cysts and management of intra-articular pathologies alone, the additional posterior open cystectomy reduced the recurrence of popliteal cysts, although it took longer to perform and brought more perioperative complications.

Baker's Cyst-Case Report

Baker's cyst is a pocket of fluid that forms a lump behind the knee. It is also called a popliteal cyst. It is usually the result of a problem with the knee joint, such as arthritis or a cartilage tear. Both the condition can cause the knee to produce too much of synovial fluid, which can leads to a baker's cyst. It tends to occur in adults from ages 35 to 70 years and above. It is common in women than in men due to inflammatory knee joint diseases such as osteoarthritis, rheumatoid arthritis etc. Popliteal cyst in adults are often secondary to degenerative or inflammatory joint disease or joint injury, they usually communicate with the adjacent knee space, especially in older patients with knee pathology communicating cyst contains synovial fluid. In children, popliteal cysts are usually a primary process, arising directly from the gastrocnemius-semimembranosus bursa, they do not communicate with the joint space. Symptoms may include; visible swelling or protrusion on the back of the knee (which can be painful or painless), constant and prolonged knee pain, and tightness at the back of the knee or simply a feeling of tenderness at the back of the knee. It can be diagnosed on by physical examination, x-ray, ultrasound, Doppler study, MRI, CT and Arthrogram. Treatment may include painkillers, R.I.C.E principles, aspiration of excess fluid with corticosteroid injection directly on the swelling. Arthroscopy surgery is done to repair any knee damage. So it is important for the nurses, nursing students to be aware of those cysts to care the client efficiently and effectively. This case report was to discuss regarding bakers cyst and its management.

Arthroscopic internal drainage and cystectomy of popliteal cyst in knee osteoarthritis

BackgroundThe purpose of this study was to evaluate the efficacy of arthroscopic knee cavity internal drainage and cyst cavity debridement operation of popliteal cyst in knee osteoarthritis patients.MethodsFrom August 2007 to March 2013, 58 knee osteoarthritis patients with popliteal cyst were treated with arthroscopic knee cavity internal drainage through posteromedial portal and popliteal cyst cavity debridement through superior posteromedial portal. In all patients, preoperative magnetic resonance imaging (MRI) was performed to detect combined intra-articular pathology and the communication between popliteal cyst and knee cavity. Clinical efficacy was evaluated through VAS score and Lysholm score.ResultsAll patients had neither recurrence of popliteal cyst nor complaints of pain, swelling, or functional impairment at average 24 months follow-up after surgery. Postoperatively, VAS score was decreased significantly and Lysholm score was raised significantly comparing preoperatively.ConclusionArthroscopic knee cavity internal drainage operation through posteromedial portal and popliteal cyst cavity debridement through superior posteromedial portal is an effective minimally invasive surgery method for the treatment of popliteal cyst without recurrence in knee osteoarthritis patients.

A comparison of clinical efficacy between different surgical approaches for popliteal cyst

BackgroundA popliteal cyst is a benign swelling with synovial fluid located behind the knee joint. Popliteal cysts are often asymptomatic; however, symptomatic cysts may cause pain and may need surgery interventions. Here, we performed a perspective study to compare the clinical efficacy of different surgical approaches, including traditional open excision and advanced arthroscopic treatment.MethodsA total of 76 patients with popliteal cysts were assigned into three groups by a randomized complete block design. Group A included 32 patients (15 males and 17 females, age 55.3 ± 9.8 years) who received arthroscopic internal drainage of the cysts. Group B included 19 patients (9 males and 10 females, age 55.4 ± 7.6 years) who received open excision after arthroscopic treatment. Group C included 25 patients (11 males and 14 females, age 54.2 ± 8.5 years) who received open excision. All patients were followed up for an average of 13.7 ± 2.4 months. The following parameters were compared: the time of surgery, during surgery, the length of incision, the incision healing rate, the visual analog scale (VAS) for pain, the hospitalization time, the rate of recovery to level 0–1 cysts, the recurrence rate, and the Lysholm score.ResultsGroup A exhibited significant better outcomes compared to groups B and C in the length of incision (1.6 ± 0.1 cm), the incision healing rate (100%), the postoperative VAS score (2.7 ± 1.2), the hospitalization time (7.8 ± 2.8 days), and the Lysholm score at the last follow-up (85.8 ± 5.2). The recurrence rate is significantly lower in groups A (3.1%) and B (5.2%) than group C (40%) (P < 0.001).ConclusionsArthroscopic treatment for popliteal cysts exhibited better clinical outcomes with minimal invasion and can be recommended for future clinical interventions.

Clinical research of popliteal cyst excision combined with debridement of the knee under arthroscopy with local anesthesia

To evaluate the clinical effects of popliteal cyst excision combined with debridement of the knee under arthroscopy with local anesthesia. From February 2009 to August 2014, 52 patients with popliteal cysts were treated in our hospital, including 34 males and 18 females with an average age of 43.6 years old ranging from 14 to 62 years old; 29 cases were on the right knee and 23 on the left knee. Preoperative diagnosis was performed according to MRI findings and to determine whether other knee disorders were associated with the disease, 52 patients were diagnosed as popliteal cyst before operation; 23 cases of simple meniscus injury or cartilage injury, 18 cases of osteoarthritis, 7 cases of cruciate ligament injury, 2 cases of gouty arthritis, 1 case of rheumatoid arthritis, 1 case of pigmented villonodular arthritis. The preoperative clinical manifestations involved knee swelling in 21 cases, knee joint pain in 16 cases, joint lock in 8 cases, leg weakness in 4 cases, and knee joint snapping in 4 cases. Cyst size was 4.0 cm× 3.3 cm to 6.2 cm× 5.3 cm. According to the Rauschning and Lindgren standards, 1 case was grade I, 9 cases were grade II, 42 cases were class III. The rehabilitation plan should be made according to the patient's specific injuries and intraoperative management. During the postoperative follow-up, the postoperative curative effect was evaluated by the standard grading of Rauschning and Lindgren of popliteal cyst. All the incisions healed by first intention, and no complications occurred. All the cases were followed up from 25 to 64 months (averaged 39.6 months). For the Rauschning and Lindgren grading, 43 cases were grade 0, 8 cases were grade I, 1 case were grade II. Local anesthesia under arthroscopy and popliteal cyst removal knee joint cavity debridement is effective, less trauma, quick recovery, short term effect is good. The recurrence rate is also low because of the primary disease of the knee joint is also treated. After the operation, the rehabilitation plan should be made according to the intraoperative treatment and actively trained so as to recover at an early date.

Musculotendinous Disorders in the Lower Leg.

AbstractMusculotendinous injury in the lower leg is associated with a variety of athletic activities. Myotendinous strain is typically localized to the posterior calf muscles, with involvement of the medial head of gastrocnemius muscle most common. Nontraumatic soft tissue injuries of the lower leg, including muscle herniation, are less frequently imaged. Ruptured popliteal cysts and deep vein thrombosis are important differential considerations in the patient presenting with acute calf pain and swelling.

Arthroscopic cystectomy for popliteal cysts in a figure 4 position

Arthroscopic cystectomy for popliteal cysts in a figure 4 position

Therapeutic effects of internal drainage by expanding arthroscopic gastrocnemius-semimembranosus bursa and cyst wall resection for the treatment of 41 patients with popliteal cysts

To investigate the clinical curative effects of internal drainage by expanding arthroscopic gastrocnemius-semimembranosus bursa(GSB) and cyst wall resection for the treatment of popliteal cysts. A retrospective analysis of patients from May 2011 to December 2015. Arthroscopic treatment for 41 patients with popliteal fossa cysts, 18 males and 23 females, aged from 34 to 67 years old, averaged 42.6 years old. All the patients had preoperative magnetic resonance imagings to confirm the diagnosis and identify the valvular opening(Gastrocnemius-Semimembranosus bursa, GSB), as well as the associated intra-articular pathology. All the popliteal cysts were unilateral, including 26 cases of right knees and 15 cases of left knees. Five patients had recurrent popliteal cysts, and all of them underwent initial open Surgery. The duration from initial surgery to the recurrence ranged from 6 to 17 months(averaged, 11 months). All the patients had underwent arthroscopic treatment of internal drainage by expanding GSB and cyst wall resection. According to the Rauschning and Lindgren classification, 5 cases were grade I , 30 cases were grade II and 6 cases were grade III. Preoperative Lysholm score, 83.19±6.12 (ranged form 73 to 95). The GSB structure was found in all patients with popliteal cysts during operation, including cartilage degeneration in 33 cases, medial meniscus injury in 27 cases, lateral meniscus injury in 7 cases, free body in 8 cases, pigmented villonodular synovitis in 2 cases, and synovial chondromatosis in 3 cases. There were no complications related to vascular, nerve or surgical incision. All the patients were followed up, and the duration ranged from 8 to 27 months, with an average of 18 months. No recurrence of cysts was found. According to the Rauschning and Lindgren classification, there were 9 cases of grade 0, 27 cases of grade I , 4 cases of grade II, 1 case of grade III. Postoperative Lysholm score:91.32±4.26(ranged from 82 to 98). Arthroscopic internal drainage by expanding GSB and cyst wall resection surgery in the treatment of popliteal cysts has the advantages of less trauma, faster recovery and low relapse rate, which has a good short-term effect.

Arthroscopic management of popliteal cyst: Comments and concerns.

Arthroscopic management of popliteal cyst: Comments and concerns.

Villonodular synovitis of the knee: about 20 cases

La synovite villonodulaire pigmentée (SVNP) est une prolifération bénigne rare de la synoviale des articulations, des bourses séreuses et des gaines tendineuses, d'étiopathogénie inconnue. Notre travail porte sur 20 cas de SVN du genou colligés à l'hôpital militaire Avicenne de Marrakech sur une période de 9 ans allant de janvier 2000 au décembre 2009 Il vise à identifier les spécificités de cette lésion, et à étudier ses principaux aspects anatomocliniques et pronostiques. L'incidence annuelle était de 2,2 cas par an. Ils étaient 15 hommes et 5 femmes, d'âge moyen de 32,5 ans, atteints du coté droit dans 55%des cas sous un mode mono articulaire chez 18 patients et bi articulaire chez un seul. La douleur et la tuméfaction étaient présentes dans 80% des cas, une masse palpable dans un cas, un syndrome méniscal a été retenu dans un cas, une mono arthrite septique dans 3 circonstances de même qu'un kyste poplité dans 2 autres. L'atteinte était diffuse dans 14 cas (70%), localisée dans 6 cas. L'imagerie par résonnance magnétique(IRM) pratiquée chez 5 patients était évocatrice chez 3, l'arthroscopie diagnostique a été utilisée chez 2 malades. La confirmation s'est faite à chaque fois à l'examen anatomopathlogique. Le traitement a consisté en une synovectomie subtotale dans 15 cas et en l'exérèse de la tumeur dans les autres formes localisées, 2 cas présentant une destruction ostéocartilagineuse ont nécessité une arthroplastie. L'évolution a été marquée par la survenue de 2 récidives sous la forme diffuse avec un recul de 3, 7 ans. On a noté une raideur avec atrophie quadricipitale chez 3 patients et une arthrolyse a été réalisée. Un cas de SVN confirmé par l'histologie s'est révélé être 5 mois après la synovectomie totale un Synovialosarcome monophasique envahissant l'os d'où l'indication de l'amputation.

Popliteal cysts in children: another look.

This retrospective review of 46 popliteal cysts seen in 44 patients at a pediatric orthopedic referral center clarifies the presenting symptomatology, associated conditions, and likely duration of a popliteal cyst, and the need for intervention. The patients were followed up for more than 1 year. Thirty-six of the 46 cysts with duration data showed no resolution of the popliteal cyst during the period of observation (average, 32.1 months). The 10 cysts that showed clinical resolution were present for an average of 16.9 months. The benign course of action for virtually all patients obviated the need for intervention and supports the adequacy of only clinical examination, with no need for recurrent sonography.

Treatment of baker cyst, by using open posterior cystectomy and supine arthroscopy on recalcitrant cases (103 knees).

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).