Department of Sports Medicine, The Third Hospital of Hebei Medical University.
Department of Orthopedics, Wanzai County Hospital of Traditional Chinese Medicine.
J Vis Exp. 2023 Oct 20(200). doi: 10.3791/65620.
Cruciate ligament cysts of the knee are a rare condition. Posterior cruciate ligament cysts of the knee are less common than anterior cruciate ligament cysts. In patients with asymptomatic isolated cruciate ligament cysts of the knee, conservative treatment is recommended. Symptomatic cruciate ligament cysts of the knee are mostly manifested as knee hyperflexion pain, straightening pain, knee discomfort after standing for a long time or walking for a long time, etc., which seriously affects the quality of life, surgical treatment can be performed. The surgical treatments can be divided into ultrasound-guided cyst puncture and fluid extraction procedure and arthroscopic cystectomy. Cysts are mostly lobulated with a multi-layer cyst wall, cyst fluid extraction does not remove the cyst wall completely but simply extracts cyst fluid, leading to a high recurrence rate. Arthroscopic surgery can completely remove the cyst wall with little trauma, a low recurrence rate, and fast postoperative recovery, so arthroscopic resection is the most common and preferred method of treatment. Since posterior cruciate ligament cysts mostly occur posterior to the ligament, we remove the cyst wall by adding a double posteromedial approach to the knee joint, and the cyst wall is removed under direct vision, which is simple to operate, the cyst wall is completely cleared, the trauma is small, the postoperative recovery is fast, and there is no recurrence. Here, 8 posterior cruciate ligament cysts were removed with complete postoperative symptom relief, no surgical complications, and no recurrence at 1-year follow-up.
膝关节十字韧带囊肿较为罕见，其中后十字韧带囊肿较前十字韧带囊肿更为少见。对于无症状的孤立性膝关节十字韧带囊肿患者，建议行保守治疗。有症状的膝关节十字韧带囊肿多表现为膝关节过伸痛、伸直痛、久站或久行后膝关节不适等，严重影响生活质量，可行手术治疗。手术治疗可分为超声引导下囊肿穿刺抽液术和关节镜下囊肿切除术。囊肿多呈分叶状，有多层囊壁，囊肿液抽吸术不能彻底清除囊壁，只是简单地抽取囊液，导致复发率较高。关节镜手术可通过小创伤彻底切除囊壁，复发率低，术后恢复快，因此关节镜下切除术是最常见和首选的治疗方法。由于后十字韧带囊肿多发生于韧带后方，我们通过在膝关节增加双后内侧入路来切除囊壁，在直视下切除囊壁，操作简单，囊壁清除彻底，创伤小，术后恢复快，无复发。在此，我们通过该方法切除了 8 例后十字韧带囊肿，术后所有患者症状均完全缓解，无手术并发症，随访 1 年均无复发。
