Comparison of therapeutic effects of arthroscopic popliteal cyst internal drainage and capsular wall resection / 中国骨伤

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.

Quiste poplíteo complicado bilateral en un paciente inmunodeprimido. Reporte de un caso / Bilateral popliteal cyst in immunosuppressed patient. Case report

Los quistes poplíteos suelen estar relacionados con enfermedades articulares degenerativas, reumatológicas o lesiones traumáticas. Las complicaciones en su evolución son infrecuentes pero deben ser tenidas en cuenta en pacientes con inmunidad alterada. Presentamos el caso de una paciente joven inmunodeprimida con un quiste poplíteo bilateral complicado y su tratamiento. Nivel de evidencia: V...

Popliteal cysts are commonly related with degenerative articular diseases, rheumathoid diseases or traumatic lesions. Complications in its evolution are infrequent but must be taken into account in patients with altered immunology. We present a case of a young immunosuppressed patient with a complicated bilateral popliteal cyst and its treatment. Level of Evidence: V...

Doença cística adventicial da artéria poplítea: causa infrequente de claudicação intermitente / Cystic adventitial disease of the popliteal artery: an infrequent cause of intermittent claudication

A claudicação intermitente está frequentemente associada à doença aterosclerótica, mas diagnósticos diferenciais devem ser pesquisados em pacientes sem fatores de risco tradicionais. A doença cística adventicial, de etiologia incerta, acomete em maior proporção a artéria poplítea e, eventualmente, apresenta-se como claudicação intermitente. Apresentamos um caso da doença e seu manejo cirúrgico, e discutimos a etiopatogenia, os aspectos diagnósticos e terapêuticos da enfermidade.

Intermittent claudication is frequently associated with atherosclerotic disease, but differential diagnosis must be sought in patients with no traditional risk factors. Cystic adventitial disease, of unknown etiology, most frequently affects the popliteal artery, and occasionally presents as intermittent claudication. We report a case of this disease and the surgical treatment, and discuss some aspects related to etiopathogenesis, diagnosis and treatment of this condition.

Resolucion artroscopica del quiste popliteo. Evaluacion preliminar. Tecnica quirurgico, año 2006 / Arthroscopic treatment of Baker cyst. Preliminar report

Introduccion: El quiste popliteo o de Baker se caracteriza por la coleccion liquida en la bursa del semimembranoso y gemelo interno. El objetivo principal del trabajo es evaluar la efectividad del tratamiento artroscopico del quiste popliteo recurrente, secundariamente detallar la tecnica quirurgica detallada. Materiales y metodos: Presentamos una serie de 6 pacientes operados entre junio del 2004 y enero del 2005 con tecnica artroscopica, con un promedio de edad de 54,8 años. Los mismos fueron estudiados por ecografia y RNM. Se incluyeron aquellos pacientes con quistes popliteos mayores a 4 cm, quienes habiendo agotado medidas conservadoras de tratamiento continuaban con sintomas. Se utilizo el store de Rauschning y Lindgren para la evaluacion clinica de los casos. El primer registro se realizo previo a la cirugia, luego a los 15 dias del postoperatorio, al mes y a los 6 meses. En este ultimo control se solicito una RNM. Resultados: Dividimos a los pacientes en 2 grupos. Aquellos a los que se les realizo la reseccion de las paredes del quiste y a los que no. A los 15 didas del postoperatorio 4 de 6 pacientes con dolor, tumefaccion y disminución del rango de movilidad presentaron movilidad completa, indolora y sin tumefacción ni edema. Dos pacientes llegaron al grado 0 al segundo control postoperatorio. Estos 2 pacientes presentaron complicaciones menores. A los 6 meses el resultado fue satisfactorio. Ningun caso presento recidivas en la RNM. Conclusiones: La resolucion artroscopica del quiste popliteo, combinado siempre con el tratamiento de las lesiones intraarticulares y la eliminación del mecanismo de válvula unidireccional mostro ser efectivo en el tratamiento del quiste popliteo. Creemos que la reseccion de las paredes del quiste aumenta la morbilidad del procedimiento.

Posterior tibial neuropathy by a Baker's cyst

Baker's cysts are rare cause of peripheral nerve entrapment and only a few cases of tibial nerve entrapment resulting from the popliteal cyst in the calf muscle have been reported in the literature. We present a case of rheumatoid arthritis complicated by a Baker's cyst with a tibial nerve entrapment. It is important to diagnose a Baker's cyst early and to differentiate it from thrombophlebitis, a popliteal aneurysm, tumor or muscle tear to effect optimal therapy and to obviate a potential neuropathy. Prompt recognition of these cases may save the patients unnecessary procedures and delay in treatment.

Enfermedad quística adventicial de la arteria poplítea / Cystic adventitial disease of the popliteal artery

Esta patología afecta principalmente a varones alrededor de la cuarta década de la vida. El trastornos simula signos y síntomas de una insuficiencia arterial crónica. La etiología de esta rara enfermedad no ha sido aún definida. Se presenta el caso de una paciente de 40 años de edad, multigesta, deportista, cuya primera manifestación fue la claudicación intermitente progresiva. Se realizaron varios estudios como arteriografía, angioplastia fallida y TAC. Se encontró en el transoperatorio, tumoración quística que envolvía el 100 por ciento del tercio medio de la arteria, practicándose resección del mismo con retiro de adventicia normal