Tie Kai, Wang Hua, Zhao Xinyu, Tan Yang, Qin Jun, Chen Liaobin
Department of Orthopaedic Surgery, Zhongnan Hospital of Wuhan University, 169# Donghu Rd, Wuchang District, Wuhan City, Hubei Provence, People's Republic of China.
J Orthop Surg Res. 2018 Apr 13;13(1):84. doi: 10.1186/s13018-018-0798-x.
Ganglion cyst of cruciate ligaments is a rare lesion; the prevalence is 0.3-0.8%. The purpose of this study was to present clinical features of symptomatic posterior cruciate ligament (PCL) cyst, introduce the arthroscopic excision technique, and evaluate the clinical outcome.
A series of 11 patients with symptomatic PCL cyst from November 2012 to December 2014 were involved in this retrospective study. Detailed medical history collecting and physical examination were conducted. Magnetic resonance imaging (MRI) scan was used to confirm the diagnosis. Arthroscopic resection was performed, and the sample of the cyst was taken for pathologic examination. The follow-up averaged 30.7 months. International Knee Documentation Committee (IKDC) score, the range of motion (ROM), and MRI evaluations were obtained pre- and postoperatively to assess the surgical outcome. SPSS software was used for statistics analysis.
Eight males and 3 females with 6 left knees and 5 right knees were enrolled, the mean age was 34.4 years, and the duration of symptom was 19.0 months. All cases had a definite history of knee trauma or injury. The most common symptom was knee pain at flexion or in flexion-associated activities. MRI revealed the location and size of the cyst in each case. Pathologic examination showed the cyst wall was composed of dense fibroconnective tissue and widespread thick bundles of collagen, which is similar to the structure of ganglion cyst. At the final follow-up, MRI evaluation showed no cyst recurrence. The preoperative ROM and IKDC score were 2.3° to 108.6° and 40.5 ± 11.3, respectively, compared with the postoperative ROM and IKDC score which were 0° to 134.1° and 85.5 ± 4.8 (p < 0.05) separately.
We conclude that the etiology of symptomatic PCL cyst is most likely associated with trauma, pain on flexion is a typical manifestation of symptomatic PCL cyst, MRI evaluation is an ideal examination for the diagnosis, and arthroscopic resection of symptomatic PCL cysts has a good outcome with no recurrence.
十字韧带腱鞘囊肿是一种罕见的病变；患病率为0.3 - 0.8%。本研究的目的是介绍有症状的后交叉韧带（PCL）囊肿的临床特征，介绍关节镜下切除技术，并评估临床结果。
本回顾性研究纳入了2012年11月至2014年12月期间的11例有症状的PCL囊肿患者。进行了详细的病史采集和体格检查。使用磁共振成像（MRI）扫描来确诊。进行了关节镜下切除，并取囊肿样本进行病理检查。随访平均为30.7个月。术前和术后获得国际膝关节文献委员会（IKDC）评分、活动范围（ROM）和MRI评估，以评估手术结果。使用SPSS软件进行统计分析。
纳入8例男性和3例女性，左膝6例，右膝5例，平均年龄34.4岁，症状持续时间为19.0个月。所有病例都有明确的膝关节创伤或损伤史。最常见的症状是膝关节在屈曲或与屈曲相关活动时疼痛。MRI显示了每个病例中囊肿的位置和大小。病理检查显示囊肿壁由致密的纤维结缔组织和广泛的粗大胶原束组成，这与腱鞘囊肿的结构相似。在最后随访时，MRI评估显示无囊肿复发。术前ROM和IKDC评分分别为2.3°至108.6°和40.5±11.3，术后ROM和IKDC评分分别为0°至134.1°和85.5±4.8（p < 0.05）。
我们得出结论，有症状的PCL囊肿的病因最可能与创伤有关，屈曲时疼痛是有症状的PCL囊肿的典型表现，MRI评估是诊断的理想检查方法，关节镜下切除有症状的PCL囊肿效果良好且无复发。
