OBJECTIVE: To investigate efficacy between arthroscopic popliteal cyst drainage and arthroscopic popliteal cyst resection. METHODS: From January 2013 to June 2021, 54 patients with popliteal cyst (Rausching-Lindgren gradeⅠto Ⅲ) were treated with arthroscopic surgery. There were 24 males and 30 females. The age ranged from 44 to 72 years old, with a mean of (62.67±6.08) years old. The course of the disease ranged from 1 to 72 months, with a mean of(15±14) months. Twenty-four patients (group A) were underwent arthroscopic internal drainage of popliteal cyst. Thirty patients (group B) were underwent arthroscopic resection of popliteal cyst. Preoperative main symptoms included knee pain, swelling, walking pain, popliteal swelling, popliteal mass and so on. After 1, 3, 6 months and 1, 2 years of surgery, routine outpatient follow-up was conducted to observe and compare the surgical time, bleeding volume, preoperative and postoperative visual analog scale (VAS), knee Lysholm score, and complications between two groups. RESULTS: All incisions healed at one stage after operation. All 54 patients were followed up, and the duration ranged from 6 months to 2 years, with an average of (13.89±4.29) months. There was no intraoperative vascular or nerve injury. Operation time and intraoperative blood loss of the two groups:group A of (62.08±9.55) min and (8.00±1.69) ml, group B of (69.50±6.99) min and (8.70±2.00) ml. Popliteal pain, swelling, limitation of flexion and extension were significantly relieved after operation. VAS before and one month after operation between two groups:group A of 5.38±1.21 and 2.63±0.71, group B of 5.60±1.26 and 2.80±0.81. Lysholm scores of knee joint before and 6 months after operation:group A of 62.59±4.99 and 89.74±2.90, group B of 63.87±3.23 and 89.02±2.35. Knee joint function improved significantly in both groups. In group A, 4 cases had popliteal cyst at 3 months after operation, and 2 cases had small isolated cyst at 1 year after operation. There was no recurrence of cyst in group B. CONCLUSION The results between two arthroscopic treatments of popliteal cyst are satisfactory, and there is no significant difference in the amount of blood loss, safety, postoperative pain VAS score and knee function recovery. It is suggested that arthroscopic resection of the cyst wall should be performed when the technique is mature, especially for large cysts and septal cysts.
Female ; Male ; Humans ; Adult ; Middle Aged ; Aged ; Popliteal Cyst/surgery* ; Drainage ; Cysts ; Knee Joint/surgery* ; Pain

OBJECTIVE: To compare the clinical effects of total arthroscopic internal drainage and arthroscopic combined with posterior small incision in the treatment of popliteal cyst. METHODS: From January 2015 to January 2017, 60 patients with popliteal cyst were treated, including 29 males and 31 females, aged 30 to 65(47.8±2.5) years old, with a course of disease (8.5±4.2) months. Among them, 30 cases received total arthroscopic internal drainage for popliteal fossa cyst(total arthroscopic group), 30 cases received arthroscopic combined with posterior small incision for popliteal fossa cyst(arthroscopic combined with small incision group). The operation time, intraoperative bleeding volume, incision length, Rauschning and Lindgren grade 0 recovery rate and Lysholm score were compared between the two groups. RESULTS: Twenty-nine patients in total arthroscopy group were followed up, and 28 patients in arthroscopy combined with small incision group were followed up for 8 to 20(12.8±2.1) months. Operation time: total arthroscopic group(45.32±5.71) min, arthroscopic combined small incision group (44.56±3.85) min; Rauschning and Lindgren grade 0 recovery: 23 cases in total arthroscopic group, 22 cases in arthroscopic combined small incision group; postoperative Lysholm score: total arthroscopic group 84.5±11.2, arthroscopic combined small incision group 83.2±12.7; there was no significant difference between the two groups(>0.05). Intraoperative bleeding volume: total arthroscopic group(5.32±1.25) ml, arthroscopic combined small incision group(20.75±8.18) ml; incision length: total arthroscopic group (1.51±0.34) cm, arthroscopic combined small incision group (7.34±0.75) cm; the difference between the two groups was significant(<0.05). At the last follow-up, the knee joint was examined by magnetic resonance imaging, and no recurrence of cyst was found. CONCLUSIONS Total arthroscopic internal drainage and arthroscopic combined with posterior small incision technique for popliteal fossa cyst with intra-articular lesions have the same clinical effect, but less trauma and faster recovery.
Adult ; Aged ; Arthroscopy ; Drainage ; Female ; Humans ; Knee Joint ; Male ; Neoplasm Recurrence, Local ; Popliteal Cyst ; Treatment Outcome

Popliteal cyst is a common peri-knee cyst, also known as a Baker's cyst. With the current development of popliteal cysts, the pathogenesis is mainly due to increased pressure in the knee joint caused by various reasons, leading to a fluid-filled sac that can form behind the knee as a result of enlargement of the gastrocnemius-semimembranosus bursa. The current diagnostic methods include X-ray computed, ultrasound, and magnetic resonance. Among them, magnetic resonance imaging is considered the gold standard for the diagnosis of popliteal cysts. There are various treatments, including conservative treatment, traditional surgical resection and arthroscopic surgery. In recent years, the focus of the treatment of popliteal cysts has gradually shifted from the simple removal of cysts to arthroscopic treatment of intra-articular lesions and the treatment of joint-cyst communication, and achieved a good effect. However, there are still controversies about the most effective treatment, and the best surgery method is still uncertained. It is hoped that high quality prospective studies will be able to directly compare different surgery methods, so as to select the best treatment for popliteal cyst. This article reviews past literature research and describes in detail the epidemiology, pathological mechanism, clinical manifestations and signs, auxiliary examination, diagnosis and differential diagnosis and clinical treatment of popliteal cysts. Different diagnosis methods and treatment methods are compared and summarized to provide basis for clinical diagnosis and treatment.
Arthroscopy ; Bursa, Synovial ; Humans ; Knee Joint ; Popliteal Cyst ; diagnosis ; therapy ; Prospective Studies

OBJECTIVE: To compare the clinical efficacy of total arthroscopic surgery and traditional surgery for popliteal cyst. METHODS: From August 2014 to July 2017, 60 cases of popliteal cyst were treated with total arthroscopy or traditional surgery respectively. In total arthroscopy group, there were 30 patients including 7 males and 23 females with an average age of (55.81±8.53) years old; the duration of the disease was (3.52±1.12) years;according to Rauschning-Lingdgren grading, 7 cases were grade I, 19 cases were grade II, 4 cases were grade III. In traditional surgical group, there were 30 patients including 5 males and 25 females with an average age of (57.93±9.84) years old; the duration of the disease was (3.48±1.34) years; according to Rauschning-Lingdgren grading, 5 cases were grade I, 21 cases were grade II, 4 cases were grade III. Preoperative symptoms involved such as arthralgia and swelling after knee joint and limited mobility. MRI confirmed a popliteal cyst. Arthroscopic surgery and traditional surgical was used respectively. Incision length, operation time, average stay, total hospital cost and Lysholm score of two groups were compared. RESULTS: In the total arthroscopic group, 1 case suffered from nerve injury, and all cases' incision healed well. In the traditional surgical group, there was 1 case of incision infection, 2 cases of poor healing, 1 case of nerve injury and 1 case of recurrence. All 60 cases were followed up for 6 to 30 months with an average of (13.3±6.5) months. After operation, the symptoms of knee joint arthralgia and swelling, discomfort were significantly improved in the two groups. There were statistically significant differences in incision length, operation time, average stay, total hospitalcost and Lysholm score 6 months after surgery(<0.05). CONCLUSIONS The total arthroscopic resection of popliteal cyst, via anterior approach to having a knee joint cavity exploration and treatment of meniscus and bursa, while combined with posteromedial approach for cyst excision would promise a minimal surgery and less pain for patients. Patients will have a rapider recovery, lower recurrence rate and less complication. The total arthroscopic resection easy to accepting for the patient and having a better clinical curative effect is obviously superior to the traditional surgery.
Aged ; Arthroscopy ; Bursa, Synovial ; Female ; Humans ; Knee Joint ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Popliteal Cyst ; Treatment Outcome

PURPOSE: To compare the clinical outcomes of the arthroscopic treatments for popliteal cysts with and without cystectomy. METHODS: PubMed/MEDLINE, EMBASE, KoreaMed, and Cochrane Library were searched from the earliest available date of indexing through August 2016. The methodological quality of all articles was assessed according to the Coleman methodology score (CMS). Studies were grouped according to the surgical method, and a meta-analysis was conducted to identify the unsuccessful clinical outcome and complication rates. RESULTS: Nine studies were included; the mean CMS was 67.33 (standard deviation, 8.75 points). Cystectomy was reported in five studies; cystectomy was not performed in four studies. The odds ratio of unsuccessful clinical outcomes evaluated by Rauschning and Lindgren score was 122.05 (p<0.001) with cystectomy and 58.12 (p<0.001) without cystectomy. The effect size of complications was 0.16 (p<0.001) with cystectomy and 0.03 (p<0.001) without cystectomy. The recurrence rate was 0% with cystectomy and 6.4% without cystectomy. CONCLUSIONS: All the currently available studies showed satisfactory outcomes in both with and without cystectomy groups. However, arthroscopic cystectomy concurrently performed with management of intra-articular lesions was associated with a relatively low recurrence rate and a relatively high incidence of complications.
Abstracting and Indexing as Topic ; Arthroscopy ; Cystectomy ; Incidence ; Knee ; Methods ; Odds Ratio ; Popliteal Cyst ; Recurrence

The authors present two cases in which the ruptured popliteal (Baker's) cysts remained undetected and were diagnosed only during an isotope investigation. The aim was to describe a specific imaging sign, the “arch sign”, that is indicative of ruptured Baker's cysts. In both cases, the whole-body imaging was performed 2 hours after injection of 706.7 MBq of Tc-99m-MDP. Single-photon emission computed tomography (SPECT) imaging was performed to localize an accumulation of the radiopharmaceutical. An analysis of literature was performed to connect these cases with previously reported data and to detect the pathognomonic radio image sign of ruptured popliteal cysts. The arch-shaped distribution of the radiopharmaceutical below the knee joints was seen already on the whole-body bone scan image in both cases. An anterior view of SPECT MIP images showed the arched accumulation of the Tc-99m-MDP bone tracer along the postero-medial aspect of the right calf secondary to synovial fluid leak from a ruptured Baker's cyst. The similar arthroscintigrams were published since 1971 without recognizing this sign as pathognomonic. Tc-99m-MDP bone scanning is sensitive for a Baker's cyst with synovial effusion, and distribution of a radiopharmaceutical in the medial posterior calf in a shape of an arch, the arch sign, may serve as an indicator of a ruptured popliteal cyst.
Knee Joint ; Popliteal Cyst ; Synovial Fluid ; Tomography, Emission-Computed ; Tomography, Emission-Computed, Single-Photon

BACKGROUND: To describe the clinical and magnetic resonance imaging findings of ganglion cysts with effusion in the flexor hallucis longus tendon sheath around the hallux to evaluate their origin. METHODS: Patients with recurrent or painful ganglion cysts around the hallux with effusion in the flexor hallucis longus tendon sheath who underwent surgical treatment at St. Vincent's Hospital from February 2007 to August 2016 were investigated. Surgical indication was a painful or recurrent mass caused by the cystic lesions. Those without effusion of the flexor hallucis longus tendon sheath were excluded. We assessed the clinical and magnetic resonance imaging findings. RESULTS: Magnetic resonance imaging findings in all patients showed several ganglion cysts around the hallux and large fluid accumulations within the flexor hallucis longus tendon sheath. Regarding the location, six ganglion cysts were on the dorsomedial aspect, one on the plantar medial aspect, seven on the plantar lateral aspect, and one in the toe pulp. Ten patients showed joint effusions in both the metatarsophalangeal and interphalangeal joints, two in the metatarsophalangeal joints, and three in the interphalangeal joints. There were communication stalks with a tail shape or abutment between ganglion cysts with surrounding joint effusions. Intraoperatively, connections between ganglion cysts, the synovial cyst of the flexor hallucis longus tendon sheath, and surrounding joints were seen. CONCLUSIONS: Synovial fluid accumulation in the metatarsophalangeal or interphalangeal joint supplies the synovial cyst of the flexor hallucis longus tendon sheath and subsequently ganglion cysts in the hallux. In clinical practice, the surgeon should carefully check surrounding joints with tendon sheaths to prevent recurrence of the ganglion cysts around the hallux.
Equipment and Supplies ; Ganglion Cysts* ; Hallux* ; Humans ; Joints ; Magnetic Resonance Imaging ; Metatarsophalangeal Joint ; Recurrence ; Synovial Cyst ; Synovial Fluid ; Tail ; Tendons* ; Toes

Two patients were admitted to our department because of recent aggravation of claudication in the leg, which was exacerbated by walking. They were diagnosed as having a Baker cyst or acute thrombosis in the popliteal fossa at another hospital. There was no evidence of ischemia, and the ankle brachial index was normal. Computed tomography and magnetic resonance imaging were performed, revealing a cystic mass of the popliteal artery (PA). Intraoperatively, the cystic lesion was found within the adventitia of the PA; based on the biopsy findings, both patients were diagnosed as having adventitial cystic disease of the PA.
Adventitia ; Ankle Brachial Index ; Biopsy ; Humans ; Ischemia ; Leg ; Magnetic Resonance Imaging ; Popliteal Artery ; Popliteal Cyst ; Thrombosis ; Walking

Intraspinal synovial cysts are rare but they are being documented with increasing frequency due to improvements in radiological imaging. However, hemorrhage into synovial cysts is uncommon, and affected patients may present with acute onset radiculopathy. This type of hemorrhage is known to result from rupture of fragile neoangiogenic vessels in the cyst wall, due to a traumatic event or anticoagulant therapy. Here, the authors present a rare case of hemorrhagic lumbar synovial cyst caused by spinal instability after microscopic discectomy. To the best of the authors’ knowledge, this is the first report of hemorrhagic lumbar synovial cyst caused by spinal instability following microscopic discectomy in the absence of a traumatic event or anticoagulant therapy. We discuss the pathophysiological mechanism of this uncommon entity and provide a review of the literature.
Diskectomy* ; Hemorrhage ; Humans ; Radiculopathy ; Rupture ; Synovial Cyst*

Lumbar intraspinal synovial cysts are included in the difference diagnosis of lumbar radiculopathy. Developing imaging modalities has result in increased reporting about these lesions. However, the case of bilateral new lumbar intraspinal synovial cysts after laminectomy has been rarely reported. We report of a rare case with bilateral lumbar intraspinal synovial cysts after laminectomy, requiring surgical excision.
Diagnosis ; Epidural Space ; Laminectomy ; Lumbar Vertebrae ; Radiculopathy ; Synovial Cyst*