Shetty Gautam M, Wang Joon Ho, Ahn Jin Hwan, Lee Yong Seuk, Kim Baek Hyun, Kim Jae Gyoon
Department of Orthopaedic Surgery, Korea University Ansan Hospital, Ansan, South Korea.
Knee Surg Sports Traumatol Arthrosc. 2008 Feb;16(2):175-8. doi: 10.1007/s00167-007-0405-x. Epub 2007 Sep 26.
Synovial cysts are well-defined fluid filled cysts that can extend for a variable distance outside the joint space. These cysts can sometimes grow to a large size making its treatment challenging especially when associated with intra-articular pathologies. We describe a case of giant synovial cyst arising from the left knee and extending to the medial proximal calf in a 77-year old female who presented with knee joint pain, episodes of locking and calf mass occurring within 2 months of onset. Imaging studies also showed associated medial and lateral meniscal tears with medial compartment and patellofemoral osteoarthritis. The cyst was treated by disrupting the valvular mechanism using a standard posteromedial portal and complete excision of the cyst wall via a posteromedial cystic portal. The meniscal lesions were dealt with through the standard anterior portals. At 25-month follow up there were no signs of recurrence of the cyst clinically or with MRI. The cystic portal technique is effective in treating a giant synovial cyst of the knee even in the presence of meniscal tears and high grade chondral lesions.
滑膜囊肿是边界清晰的充满液体的囊肿，可在关节间隙外延伸不同距离。这些囊肿有时会生长到很大尺寸，使其治疗具有挑战性，尤其是当与关节内病变相关时。我们描述了一例77岁女性患者，左膝出现巨大滑膜囊肿并延伸至小腿近端内侧，患者在发病2个月内出现膝关节疼痛、交锁发作和小腿肿块。影像学检查还显示伴有内侧和外侧半月板撕裂以及内侧间室和髌股关节炎。通过使用标准后内侧入路破坏瓣膜机制，并通过后内侧囊肿入路完全切除囊肿壁来治疗该囊肿。半月板损伤通过标准前外侧入路处理。在25个月的随访中，临床及MRI检查均未发现囊肿复发迹象。即使存在半月板撕裂和高级别软骨损伤，囊肿入路技术在治疗膝关节巨大滑膜囊肿方面也是有效的。
