Pankaj Amite, Chahar Deepak, Pathrot Devendra
Department of Orthopedics University College of Medical Sciences and Guru Teg Bahadur Hospital, New Delhi, India.
Indian J Orthop. 2016 Mar-Apr;50(2):154-8. doi: 10.4103/0019-5413.177568.
Management of popliteal cyst is controversial. Owing to high failure rates in open procedures, recent trend is towards arthroscopic decompression and simultaneous management of intraarticular pathology. We retrospectively analysed clinical results of symptomatic popliteal cysts after arthroscopic management at 24 month followup.
Retrospective analysis of hospital database for patients presenting with pathology suggestive of a popliteal cyst from June 2007 to December 2012 was done. Twelve cases of popliteal cyst not responding to NSAIDS and with Rauschning and Lindgren Grade 2 or 3 who consented for surgical intervention were included in the study. All patients underwent arthroscopic decompression using a posteromedial portal along with management of intraarticular pathologies as encountered. Furthermore, the unidirectional valvular effect was corrected to a bidirectional one by widening the cyst joint interface. The results were assessed as per the Rauschning and Lindgren criteria.
All patients were followed for a minimum of 24 months (range 24-36 months). It revealed that among the study group, six patients achieved Grade 0 status while five had a minimal limitation of range of motion accompanied by occasional pain (Grade 1). One patient had a failure of treatment with no change in the clinical grading.
Arthroscopic approach gives easy access to decompression with the simultaneous management of articular pathologies.
腘窝囊肿的治疗存在争议。由于开放手术的失败率较高,近来的趋势是采用关节镜下减压并同时处理关节内病变。我们对关节镜治疗后有症状的腘窝囊肿患者进行了24个月随访的临床结果进行回顾性分析。
对2007年6月至2012年12月期间医院数据库中出现提示腘窝囊肿病变的患者进行回顾性分析。本研究纳入了12例对非甾体抗炎药无反应且Rauschning和Lindgren分级为2级或3级并同意手术干预的腘窝囊肿患者。所有患者均通过后内侧入路进行关节镜下减压,并同时处理术中遇到的关节内病变。此外,通过扩大囊肿关节界面将单向瓣膜效应纠正为双向瓣膜效应。根据Rauschning和Lindgren标准评估结果。
所有患者至少随访24个月(范围24 - 36个月)。结果显示,在研究组中,6例患者达到0级状态,5例患者的活动范围有轻微受限并伴有偶尔疼痛(1级)。1例患者治疗失败,临床分级无变化。
关节镜入路便于进行减压,同时可处理关节病变。