Clinical Results of Direct Arthroscopic Excision of Popliteal Cyst Using a Posteromedial Portal
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Purpose: To evaluate the efficacy of the direct arthroscopic excision of a popliteal cyst without additional skin incision using a posteromedial portal based on minimum 2 year follow-up clinical results. Materials and Methods: From January 2003 to January 2010, 105 patients (111 cases) with popliteal cyst have been treated by a direct arthroscopic excision. Direct arthroscopic excision using a 70 degree arthroscopy and posteromedial portal can correct the valvular mechanism of capsular fold and reduce the complications with no additional skin incision at the popliteal area. In all cases, preoperative magnetic resonance imaging (MRI) was performed to detect combined intraarticular pathology. At 2 years postoperatively, a follow-up ultrasonography or MRI was performed to detect the recurrence of cysts. We used Rauschning and Lindgren criteria for clinical evaluation. Results: All cases had neither recurrence nor complaints of pain, swelling, or functional impairment more than 2 years after the surgery. At ultrasonography or MRI, no recurrence was found, and 5 complications were 1 skin lesion and 4 hematoma. Postoperatively, Rauschning and Lindgren criteria were more than grade 1. Conclusions: Direct arthroscopic excision using 70 degree arthroscope and posteromedial portal is an effective method for the treatment of popliteal cyst.
Abstract
Purpose: To evaluate the efficacy of the direct arthroscopic excision of a popliteal cyst without additional skin incision using a posteromedial portal based on minimum 2 year follow-up clinical results. Materials and Methods: From January 2003 to January 2010, 105 patients (111 cases) with popliteal cyst have been treated by a direct arthroscopic excision. Direct arthroscopic excision using a 70 degree arthroscopy and posteromedial portal can correct the valvular mechanism of capsular fold and reduce the complications with no additional skin incision at the popliteal area. In all cases, preoperative magnetic resonance imaging (MRI) was performed to detect combined intraarticular pathology. At 2 years postoperatively, a follow-up ultrasonography or MRI was performed to detect the recurrence of cysts. We used Rauschning and Lindgren criteria for clinical evaluation. Results: All cases had neither recurrence nor complaints of pain, swelling, or functional impairment more than 2 years after the surgery. At ultrasonography or MRI, no recurrence was found, and 5 complications were 1 skin lesion and 4 hematoma. Postoperatively, Rauschning and Lindgren criteria were more than grade 1. Conclusions: Direct arthroscopic excision using 70 degree arthroscope and posteromedial portal is an effective method for the treatment of popliteal cyst.
참고문헌 (18)
- Cho DY, "The management of Baker’s cyst (the new surgical technique for the prevention of recurrence)", J Korean Orthop Assoc, 29, pp.288~293 (1994)
- Kanekasu K, "A clinical study of arthroscopic cystectomy on popliteal cysts associated with rheumatoid arthritis", Ryumachi, 37, pp.761~769 (1997)
- Lindgren PG., "Gastrocnemio-semimembranosus bursa and its relation to the knee joint. III. Pressure measurements in joint and bursa", Acta Radiol Diagn(Stockh), 19, pp.377~388 (1978)
- Sansone V, "Arthroscopic treatment of popliteal cyst and associated intra-articular knee disorders in adults", Arthroscopy, 15, pp.368~372 (1999)
- Smith JT, "Benign soft-tissue lesions in children", Orthop Clin North Am, 27, pp.645~654 (1996)
- Johnson LL, "The popliteal bursa (Baker’s cyst): an arthroscopic perspective and the epidemiology", Arthroscopy, 13, pp.66~72 (1997)
- Rauschning W, "Popliteal cysts (Baker’s cysts) in adults. I. Clinical and roentgenological results of operative excision", Acta Orthop Scand, 50, pp.583~591 (1979)
- Vahvanen V, "A follow-up study on 42 operatively treated patients", Acta Orthop Scand, 44, pp.303~310 (1973)
- 고상훈, "관절경을 이용한 슬와낭종의 직접적 절삭절제술", 대한정형외과학회지, 37(3), pp.8~368 (2002), 대한정형외과학회
- Ahn JH, "Arthroscopic cystectomy for popliteal cysts through the posteromedial cystic portal", Arthroscopy, 23, pp.559~ (2007)
- Ko S, "Popliteal cystoscopic excisional debridement and removal of capsular fold of valvular mechanism of large recurrent popliteal cyst", Arthroscopy, 20, pp.37~44 (2004)
- Rauschning W, "Popliteal cysts (Baker’s cysts) in adults. II. Capsuloplasty with and without a pedicle graft", Acta Orthop Scand, 51, pp.547~555 (1980)
- Gristina AG, "Popliteal cysts in adults and children. A review of 90 cases", Arch Surg, 88, pp.357~363 (1964)
- Fujikawa K, "Arthrographic study of the rheumatoid knee. Part 1. Synovial proliferation", Ann Rheum Dis, 40, pp.332~343 (1981)
- Moore CP, "Ultrasonographic demonstration of popliteal cysts in rheumatoid arthritis. A noninvasive technique", Arthritis Rheum, 18, pp.577~580 (1975)
- Childress HM, "Popliteal cysts associated with undiagnosed posterior lesions of the medial meniscus. The significance of age in diagnosis and treatment", J Bone Joint Surg Am, 52, pp.1487~1492 (1970)
- Hughston JC, "Popliteal cyst : a surgical approach", Orthopedics, 14, pp.147~150 (1991)
- Lindgren PG, "Gastrocnemio-semimembranosus bursa and its relation to the knee joint. I. Anatomy and histology", Acta Radiol Diagn(Stockh), 18, pp.497~512 (1977)