Arthroscopic Decompression of a Popliteal Cyst
Background: Popliteal (Baker) cysts are enlarged gastrocnemius-semimembranosus bursae leading to swelling in the popliteal fossa. Surgical decompression and capsulectomy is the definitive treatment for symptomatic cysts with arthroscopic or open decompression. Arthroscopic decompression is minimally...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2023-05-01
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| Series: | Video Journal of Sports Medicine |
| Online Access: | https://doi.org/10.1177/26350254231168156 |
| _version_ | 1797798190399881216 |
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| author | Brian Forsythe MD Vikranth R. Mirle BS Vince K. Morgan MD Vahram Gamsarian BE Hasani Swindell MD Christopher Brusalis MD |
| author_facet | Brian Forsythe MD Vikranth R. Mirle BS Vince K. Morgan MD Vahram Gamsarian BE Hasani Swindell MD Christopher Brusalis MD |
| author_sort | Brian Forsythe MD |
| collection | DOAJ |
| description | Background: Popliteal (Baker) cysts are enlarged gastrocnemius-semimembranosus bursae leading to swelling in the popliteal fossa. Surgical decompression and capsulectomy is the definitive treatment for symptomatic cysts with arthroscopic or open decompression. Arthroscopic decompression is minimally invasive, entails lower risks, and allows for earlier and more aggressive rehabilitation compared with open excision. Indications: Indications for popliteal cyst decompression include pain and mechanical discomfort refractory to conservative treatment. Further indications are neurovascular compromise secondary to bursal enlargement, including thrombophlebitis, compartment syndrome, limb ischemia, and nerve entrapment. Additional considerations include concurrent pathology requiring surgical intervention. Technique Description: Following standard diagnostic arthroscopy, a Gillquist maneuver is performed to visualize the posteromedial compartment and transverse synovial fold. The operative limb is placed in a modified figure-of-four position. A posteromedial portal is established under spinal needle localization and utilized to debride the anterior capsular wall and cyst contents with an arthroscopic shaver. Attention is paid to the removal of the posterior transverse synovial infold to reduce risk of recurrence. Results: The literature reports favorable outcomes in arthroscopic decompression of popliteal cysts. In comparison of arthroscopic and open decompression, You et al. reported reduced mean operative time and reduced recurrence rate following arthroscopic management. In a retrospective study, Rupp et al. reported increased rates of cyst recurrence with concurrent meniscal and/or chondral injuries highlighting the importance of addressing concurrent intra-articular pathologies during decompression. Discussion/Conclusion: Arthroscopic decompression of symptomatic popliteal cysts can be performed safely and effectively. Arthroscopic approach allows for treatment of concurrent pathologies that predispose to increased rates of cyst recurrence. Nonetheless, rates of recurrence vary widely and therefore further study in treatment technique is necessary. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication. |
| first_indexed | 2024-03-13T03:59:45Z |
| format | Article |
| id | doaj.art-2f6fc6ba5bbc44eba271511dc42e53c7 |
| institution | Directory Open Access Journal |
| issn | 2635-0254 |
| language | English |
| last_indexed | 2024-03-13T03:59:45Z |
| publishDate | 2023-05-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Video Journal of Sports Medicine |
| spelling | doaj.art-2f6fc6ba5bbc44eba271511dc42e53c72023-06-21T15:33:25ZengSAGE PublishingVideo Journal of Sports Medicine2635-02542023-05-01310.1177/26350254231168156Arthroscopic Decompression of a Popliteal CystBrian Forsythe MD0Vikranth R. Mirle BS1Vince K. Morgan MD2Vahram Gamsarian BE3Hasani Swindell MD4Christopher Brusalis MD5Midwest Orthopaedics at RUSH, RUSH University Medical Center, Chicago, Illinois, USAPritzker School of Medicine, The University of Chicago, Chicago, Illinois, USAMidwest Orthopaedics at RUSH, RUSH University Medical Center, Chicago, Illinois, USAUniversity of Michigan Medical School, Ann Arbor, Michigan, USADepartment of Orthopaedic Surgery, Columbia University, New York City, New York, USAMidwest Orthopaedics at RUSH, RUSH University Medical Center, Chicago, Illinois, USABackground: Popliteal (Baker) cysts are enlarged gastrocnemius-semimembranosus bursae leading to swelling in the popliteal fossa. Surgical decompression and capsulectomy is the definitive treatment for symptomatic cysts with arthroscopic or open decompression. Arthroscopic decompression is minimally invasive, entails lower risks, and allows for earlier and more aggressive rehabilitation compared with open excision. Indications: Indications for popliteal cyst decompression include pain and mechanical discomfort refractory to conservative treatment. Further indications are neurovascular compromise secondary to bursal enlargement, including thrombophlebitis, compartment syndrome, limb ischemia, and nerve entrapment. Additional considerations include concurrent pathology requiring surgical intervention. Technique Description: Following standard diagnostic arthroscopy, a Gillquist maneuver is performed to visualize the posteromedial compartment and transverse synovial fold. The operative limb is placed in a modified figure-of-four position. A posteromedial portal is established under spinal needle localization and utilized to debride the anterior capsular wall and cyst contents with an arthroscopic shaver. Attention is paid to the removal of the posterior transverse synovial infold to reduce risk of recurrence. Results: The literature reports favorable outcomes in arthroscopic decompression of popliteal cysts. In comparison of arthroscopic and open decompression, You et al. reported reduced mean operative time and reduced recurrence rate following arthroscopic management. In a retrospective study, Rupp et al. reported increased rates of cyst recurrence with concurrent meniscal and/or chondral injuries highlighting the importance of addressing concurrent intra-articular pathologies during decompression. Discussion/Conclusion: Arthroscopic decompression of symptomatic popliteal cysts can be performed safely and effectively. Arthroscopic approach allows for treatment of concurrent pathologies that predispose to increased rates of cyst recurrence. Nonetheless, rates of recurrence vary widely and therefore further study in treatment technique is necessary. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.https://doi.org/10.1177/26350254231168156 |
| spellingShingle | Brian Forsythe MD Vikranth R. Mirle BS Vince K. Morgan MD Vahram Gamsarian BE Hasani Swindell MD Christopher Brusalis MD Arthroscopic Decompression of a Popliteal Cyst Video Journal of Sports Medicine |
| title | Arthroscopic Decompression of a Popliteal Cyst |
| title_full | Arthroscopic Decompression of a Popliteal Cyst |
| title_fullStr | Arthroscopic Decompression of a Popliteal Cyst |
| title_full_unstemmed | Arthroscopic Decompression of a Popliteal Cyst |
| title_short | Arthroscopic Decompression of a Popliteal Cyst |
| title_sort | arthroscopic decompression of a popliteal cyst |
| url | https://doi.org/10.1177/26350254231168156 |
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