Clinical outcome of arthroscopic management of popliteal cysts with or without additional posterior open cystectomy.

Purpose: The aim of this retrospective study was to compare the clinical outcomes of arthroscopic decompression of popliteal cysts and simultaneous management of intra-articular pathologies alone or in combination with posterior open cystectomy.

Material And Methods: This study included 65 consecutive patients with the diagnosis of popliteal cysts. Of the patients 31 received arthroscopy alone (arthroscopic decompression of cysts and management of intra-articular pathologies, AA group) and 34 received arthroscopy combined with open cystectomy (AO group). At the last follow-up after a mean of 33.3 months, magnetic resonance imaging (MRI) scans were performed to assess the outcomes of cysts and functional scores. The Lysholm score and Rauschning and Lindgren grade were used for clinical evaluation.

Results: The procedure in the AA group took less time to perform and resulted in less postoperative complications in the perioperative period. At the last follow-up, no significant differences were observed between the groups in terms of the Lysholm score or Rauschning and Lindgren grade (P > 0.05). The results of MRI showed that the cysts disappeared in 17 (55%) patients, reduced in 9 (29%) patients and persisted in 5 (16%) patients in the AA group, and disappeared in 29 (85%) patients, reduced in 4 (12%) patients and persisted in 1 (3%) patients in the AO group, which was significantly different (P < 0.05). In the AA group 6 patients and 1 in the AO group were grade 2 or 3 and needed a second operation (arthroscopy combined with open cystectomy), which was significantly different (P < 0.05).

Conclusion: In comparison to arthroscopic decompression of cysts and management of intra-articular pathologies alone, the additional posterior open cystectomy reduced the recurrence of popliteal cysts, although it took longer to perform and brought more perioperative complications.