Xinxian Xu, Yuezheng Hu, Jian Lin, Huachen Yu
The Osteopathy Department, the Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, Zhejiang Province, China.
Orthopade. 2018 Jun;47(6):530-535. doi: 10.1007/s00132-018-3573-0.
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.
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.
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).
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.
本回顾性研究旨在比较单独进行腘窝囊肿关节镜减压及同时处理关节内病变，与联合后外侧开放囊肿切除术的临床疗效。
本研究纳入65例连续诊断为腘窝囊肿的患者。其中31例患者仅接受关节镜手术（关节镜下囊肿减压及关节内病变处理，AA组），34例患者接受关节镜联合开放囊肿切除术（AO组）。平均随访33.3个月后，行磁共振成像（MRI）扫描以评估囊肿转归及功能评分。采用Lysholm评分和Rauschning及Lindgren分级进行临床评估。
AA组手术时间较短，围手术期术后并发症较少。末次随访时，两组间Lysholm评分或Rauschning及Lindgren分级无显著差异（P>0.05）。MRI结果显示，AA组囊肿消失17例（55%），缩小9例（29%），持续存在5例（16%）；AO组囊肿消失29例（85%），缩小4例（12%），持续存在1例（3%），差异有统计学意义（P<0.05）。AA组6例患者和AO组1例患者为2级或3级，需要二次手术（关节镜联合开放囊肿切除术），差异有统计学意义（P<0.05）。
与单纯关节镜下囊肿减压及关节内病变处理相比，额外的后外侧开放囊肿切除术虽手术时间较长且围手术期并发症较多，但可降低腘窝囊肿的复发率。
