A comparison of clinical efficacy between different surgical approaches for popliteal cyst
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RESEARCH ARTICLE
Open Access
A comparison of clinical efficacy between different surgical approaches for popliteal cyst Bo Yang*† , Fengchun Wang†, Yanhua Lou†, Juan Li, Lei Sun, Lei Gao and Feng Liu
Abstract Background: A popliteal cyst is a benign swelling with synovial fluid located behind the knee joint. Popliteal cysts are often asymptomatic; however, symptomatic cysts may cause pain and may need surgery interventions. Here, we performed a perspective study to compare the clinical efficacy of different surgical approaches, including traditional open excision and advanced arthroscopic treatment. Methods: A total of 76 patients with popliteal cysts were assigned into three groups by a randomized complete block design. Group A included 32 patients (15 males and 17 females, age 55.3 ± 9.8 years) who received arthroscopic internal drainage of the cysts. Group B included 19 patients (9 males and 10 females, age 55.4 ± 7. 6 years) who received open excision after arthroscopic treatment. Group C included 25 patients (11 males and 14 females, age 54.2 ± 8.5 years) who received open excision. All patients were followed up for an average of 13.7 ± 2. 4 months. The following parameters were compared: the time of surgery, during surgery, the length of incision, the incision healing rate, the visual analog scale (VAS) for pain, the hospitalization time, the rate of recovery to level 0–1 cysts, the recurrence rate, and the Lysholm score. Results: Group A exhibited significant better outcomes compared to groups B and C in the length of incision (1.6 ± 0.1 cm), the incision healing rate (100%), the postoperative VAS score (2.7 ± 1.2), the hospitalization time (7.8 ± 2.8 days), and the Lysholm score at the last follow-up (85.8 ± 5.2). The recurrence rate is significantly lower in groups A (3.1%) and B (5.2%) than group C (40%) (P < 0.001). Conclusions: Arthroscopic treatment for popliteal cysts exhibited better clinical outcomes with minimal invasion and can be recommended for future clinical interventions. Keywords: Arthroscopy, Popliteal cyst, Internal drainage, Open excision
Background Popliteal cyst is a common knee joint disease and often seen in elderly patients with knee osteoarthritis or meniscus tear [1, 2]. Traditionally, treatment usually involves open excision from the posterior side of the knee. However, it requires a large incision and is associated with high recurrence rates [3, 4]. It is becoming a commonplace that understanding pathological progression underlying popliteal cysts is beneficial for the current treatment [5]. In recent years, minimally invasive * Correspondence: [email protected] † Equal contributors Department of Orthopaedics, Tai’an Central Hospital, Tai’an, Shandong 271000, China
arthroscopy has provided surgeons an alternative approach with prominent advantages [6, 7]. However, arthroscopic treatment alone may not be enough to address both the underlying pathology in the knee joint and the cyst [8]. On the other hand, the combination of arthroscopic treatment and open excision was rarely re
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