Arthroscopic Treatment of Popliteal Cysts: Clinical and Magnetic Resonance Imaging Results

Ahn, Jin Hwan; Lee, Sang Hak; Yoo, Jae Chul; Chang, Moon Jong; Park, Yong Serk

doi:10.1016/j.arthro.2010.02.012

« Previous Next »Arthroscopy: The Journal of Arthroscopic and Related Surgery
Volume 26, Issue 10 , Pages 1340-1347, October 2010

Arthroscopic Treatment of Popliteal Cysts: Clinical and Magnetic Resonance Imaging Results

Jin Hwan Ahn, M.D.
- Department of Orthopaedic Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea
Sang Hak Lee, M.D.
- Department of Orthopaedic Surgery, School of Medicine, Chung-Ang University, Seoul, South Korea
- Address correspondence and reprint requests to Sang Hak Lee, M.D., Department of Orthopaedic Surgery, School of Medicine, Chung-Ang University, 224-1, Heukseok-dong, Dongjak-ku, Seoul, 140-757, South Korea
Jae Chul Yoo, M.D.
- Department of Orthopaedic Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea
Moon Jong Chang, M.D.
- Department of Orthopaedic Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea
Yong Serk Park, M.D.
- Department of Orthopaedic Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea

Received 3 July 2009; accepted 10 February 2010. published online 27 September 2010.

Purpose

This study examined the functional and magnetic resonance imaging (MRI) outcomes of popliteal cysts with combined intra-articular pathologies that were treated arthroscopically by decompression and a cystectomy through an additional posteromedial cystic portal.

Methods

From January 2003 to March 2008, 31 patients were treated with a modified arthroscopic technique to decompress a popliteal cyst. The connecting valvular mechanism was found in all cases at the posteromedial compartment through the anterolateral viewing portal, and it was corrected by resecting the capsular fold through the posteromedial working portal. For cysts with multiple fibrous septa, an additional portal, the so-called posteromedial cystic portal, was used for complete cyst removal. The functional outcome was evaluated by use of the Rauschning and Lindgren knee score. All patients were evaluated by MRI, which documented the popliteal cyst and associated intra-articular lesions preoperatively and at follow-up.

Results

All patients could return to their previous daily activities with few or no limitations, and no additional surgery was required after a mean follow-up of 36.1 months (range, 12 to 72 months). The Rauschning and Lindgren knee score showed improved clinical features at the final follow-up in 94% of patients. The follow-up MRI study showed that the cyst had disappeared in 17 knees (55%) and had reduced in size in 14 knees (45%) in the 31 patients. The mean cyst size was reduced significantly from 6.8 to 0.8 cm (P < .0001).

Conclusions

The described arthroscopic technique with or without an additional posteromedial cystic portal is effective for treating popliteal cysts with combined intra-articular lesions. More importantly, follow-up MRI showed that the cyst size was reduced or it had disappeared in all cases, although there was no association between the cyst's disappearance and the follow-up clinical score.