Purpose
To determine if cyst management is necessary in the setting of SLAP lesions with concomitant
paralabral ganglion cysts.
Methods
We performed a systematic review according to Preferred Reporting Items for Systematic
Reviews and Meta-analyses (PRISMA) guidelines, including all studies that met inclusion
criteria from January 1975 to July 2015. We included patients with a SLAP II-VII lesion
and a concomitant paralabral ganglion cyst who underwent arthroscopic labral repair
with or without cyst decompression. Patients with follow-up of less than 3 months,
a SLAP I lesion, or who underwent concomitant cuff repair were excluded. The Methodological
Index for Non-randomized Studies (MINORS) scoring system was used to quantify the
potential bias in each study. Outcome measures reported were provided in a table format
and a subjective analysis was performed.
Results
Nineteen studies were included yielding a total of 160 patients: 66 patients treated
with repair alone [R] and 94 patients with additional cyst decompression or excision
[R+D]. The VAS, Rowe, and Constant scores were excellent and similar in both groups.
The mean VAS was 0.6 in [R] and ranged between 0 and 2 in [R+D] (0.5, 0, 2, 0.2).
The mean Rowe scores were 94 and 98 in [R] and 95 in [R+D]. The mean Constant scores
were 97 in [R] and ranged between 87 and 98 in [R+D] (98, 87, 92, 94). In total, 5
of 90 patients were unable to return to work and 2 of 45 were unable to return to
sport. All 15 patients who had follow-up electromyographies displayed resolution,
and in the 115 patients with follow-up MRIs, 12 did not have complete resolution of
the cyst.
Conclusions
Despite the lack of high-quality evidence, the studies subjectively analyzed in this
review suggest that both groups have excellent results. The results do not show any
advantages from performing decompression.
Level of Evidence
Level IV, systematic review of Level II and Level IV studies.
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Article Info
Publication History
Published online: February 28, 2018
Accepted:
January 18,
2018
Received:
October 11,
2017
Footnotes
See commentary on page 2254
The authors report that they have no conflicts of interest in the authorship and publication of this article. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Identification
Copyright
© 2018 Published by Elsevier on behalf of the Arthroscopy Association of North America
