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An arthroscopic Resection Technique for Popliteal Cysts

ABSTRACT: When treating a popliteal cyst in the knee joint, it is often necessary to simultaneously treat the intra-articular lesions so as to reduce the recurrence of the cyst after the operation. Herein, we propose an arthroscopic resection technique for popliteal cyst, in which the position of the popliteal cyst is indirectly located by finding out the location of the semimembranosus tendon during the operation, thereby completing the arthroscopic resection of the popliteal cyst. This method does not involve the posteromedial compartment of the knee joint. Arthroscopic treatment can be performed on the combined intra-articular lesions through anteromedial and anterolateral approaches before or after popliteal cyst resection. Technique Video Video 1 This is a patient with a right popliteal cyst. After the operative approach was established according to step 2, the arthroscope was implanted through approach 1, and a motorized shaver was implanted through approach 2. We clean the surrounding soft tissue to look for the semimembranosus tendon, and the popliteal cyst will be found on the lateral side of the semimembranosus tendon. Finally, we cleaned the cyst wall tissue completely.

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PROVIDER: S-EPMC9596819 | biostudies-literature | 2022 Sep

REPOSITORIES: biostudies-literature

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Project description:ObjectivePotential disadvantages of open technique for talocalcaneal coalition (TCC) include a risk of wound infection, opioid drug dependence, and prolonged hospitalization. The purpose of this study was to retrospectively evaluate the effectiveness and safety of endoscopic resection of the TCC.MethodsA retrospective study from June 2019 to February 2023was conducted on 16 consecutively admitted patients who were diagnosed by imaging to have TCC for whom conservative treatment had failed and who undergone arthroscopic resection. The mean age of this cohort was 31.56 ± 10.39 years (range, 16-57 years). The mean follow-up period was 38.93 ± 15.69 months (range, 11-59 months). The site of the coalition, comorbidities, satisfaction with treatment, visual analog scale (VAS), and American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot scale scores were evaluated pre- and postoperatively. Preoperative magnetic resonance imaging (MRI) scans were used to categorize the coalition according to the Lim classification. Postoperative computed tomography (CT) scans were used to assess recurrence. The distribution of TCC cases according to the Lim classification was type I in one case, type II in four cases, and type III in 11 cases.ResultsThe site of coalition involved the middle facets in seven patients, the posterior facets in three patients, and both the above sites in six patients. All patients underwent total arthroscopic resection of TCC. An auxiliary mini-incision was made for three patients due to serious tibial nerve compression. Radiographics showed that the coalition disappeared and pain was relieved postoperatively. The mean VAS score decreased from 4.31 ± 1.54 to 1.81 ± 0.98 points (p < 0.001). The mean AOFAS ankle-hindfoot score improved from 65.56 ± 5.82 to 87.31 ± 6.30 points (p < 0.001). Fifteen patients were satisfied with the procedure, and one patient experienced numbness after surgery. No recurrence was reported based on CT scan and clinical results up to the end of the study.ConclusionSurgical reconstruction employing total arthroscopic resection of TCC can achieve significant functional and radiographic improvements and symptom relief in selected patients with TCC. Auxiliary mini-incisions were necessitated in complex situations.

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An arthroscopic Resection Technique for Popliteal Cysts

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