Takahashi Masaaki, Nagano Akira
Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan.
Arthroscopy. 2005 May;21(5):638. doi: 10.1016/j.arthro.2005.02.007.
In regard to arthroscopic treatment of popliteal cysts, we explored the refuted pathology for popliteal cysts proposed by others. Here we introduce an arthroscopic technique using posterior portals to treat a popliteal cyst based on our observation that the opening of the cyst in the joint is a slit-like structure in the posterior wall of the capsule. By disrupting this slit-like structure with our procedure, the popliteal cyst ceased to be palpable and was no longer symptomatic. This technique also provides excellent arthroscopic visualization of the cavity of the popliteal cyst through the knee joint approach. After completion of the resection of the opening, we can easily insert an arthroscope into the cavity of the popliteal cyst from the posteromedial portal through the resected opening. Arthroscopic visualization of the cavity of the cyst showed that the inside wall of the cavity was smooth and had no synovitis. We believe that to disrupt this slit structure is the most pathologically reasonable procedure to treat popliteal cysts surgically.
关于腘窝囊肿的关节镜治疗,我们探讨了其他人提出的关于腘窝囊肿的被驳斥的病理学观点。在此,基于我们的观察结果,即囊肿在关节内的开口是关节囊后壁的一个裂隙样结构,我们介绍一种使用后入路的关节镜技术来治疗腘窝囊肿。通过我们的操作破坏这个裂隙样结构后,腘窝囊肿不再能被摸到,且不再有症状。该技术还通过膝关节入路提供了对腘窝囊肿腔的极佳关节镜视野。在完成开口切除后,我们可以很容易地通过切除的开口从后内侧入路将关节镜插入腘窝囊肿腔内。关节镜下对囊肿腔的观察显示,腔的内壁光滑,没有滑膜炎。我们认为破坏这个裂隙结构是手术治疗腘窝囊肿在病理上最合理的操作。