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Arthroscopic internal drainage of popliteal cysts with cyst wall resection in pediatric patients
Junxu Zhu1, Dulei Xiang2, Shen Yang3
1Junxu Zhu, The General Hospital of North Theater Command Training Base, Jinzhou Medical University Graduate, Shenyang 110016 Liaoning, People's Republic of China; Department of Orthopaedics, Xiangyang Hospital of Traditional Chinese Medicine, Xiangyang 441000 Hubei, People's Republic of China.
Insights
Arthroscopic internal drainage and cyst wall resection effectively treat pediatric popliteal cysts, showing significant improvement and no recurrence. This minimally invasive approach promotes faster recovery in children.
Area of Science:
- Orthopedic Surgery
- Pediatric Surgery
- Arthroscopy
Background:
- Popliteal cysts are common in children, often causing discomfort and limited mobility.
- Surgical intervention is sometimes necessary for persistent or symptomatic popliteal cysts.
Purpose of the Study:
- To evaluate the efficacy of arthroscopic internal drainage (AID) and cyst wall resection (CWR) in pediatric patients with popliteal cysts.
- To assess the safety and outcomes of this minimally invasive surgical approach.
Main Methods:
- Sixteen pediatric patients with popliteal cysts underwent arthroscopy using a double posteromedial portal system.
- Procedures included AID plus CWR, with outcomes assessed using Rauschning and Lindgren criteria.
- Preoperative MRI was used to evaluate cyst characteristics and intra-articular communication.
Main Results:
- All patients showed significant improvement post-surgery, with 15 achieving grade-0 and one grade-1 popliteal cysts.
- No major complications, including vascular or nerve injury, wound infection, or deep venous thrombosis, were reported.
- No recurrence of popliteal cysts was observed during the 3-12 month follow-up period.
Conclusions:
- Arthroscopic internal drainage plus cyst wall resection is a safe and effective treatment for pediatric popliteal cysts.
- This minimally invasive technique leads to favorable postoperative recovery and low recurrence rates.
Objectives:
To evaluate the efficacy of arthroscopic internal drainage (AID) and cyst wall resection (CWR) in children with popliteal cysts.
Methods:
This study included 16 pediatric patients with popliteal cysts and received arthroscopy using the double posteromedial (PM) portal system during June 2020 and June 2021 at The General Hospital of Northern Theater Command. Among these pediatric patients, 14 were males and two were females, with the mean age of nine years (range: 7-12 years). The left knee was affected in 12 cases, while the right knee was involved in the rest four cases. All patients underwent MR imaging before the procedure to assess whether there was intra-articular trauma and whether the popliteal cyst communicated with the knee-joint cavity. The MRI results showed that each patient had a simple popliteal cyst that involved a single knee joint without intra-articular trauma, which was classified as Grade-1 (n=3), Grade-2 (n =10) or Grade-3 (n =3) according to the Rauschning and Lindgren grading of knee joint symptoms. Arthroscopy was performed through anterolateral (AL) and PM portals to the knee joint for AID plus CWR, and the surgical outcomes were evaluated based on the Rauschning and Lindgren criteria.
Results:
No major vascular or nerve injury occurred during the operation. Postoperative complications such as wound infection and lower-extremity deep venous thrombosis were not recorded in these patients. Complications involving the saphenous nerve or the great saphenous vein or pseudocyst formation were not observed during the follow-up period. All patients completed the follow-up ranging from 3-12 months and were identified to have grade-0 (n=15) and grade-1 (n=1) popliteal cysts based on the Rauschning and Lindgren criteria, indicating significant improvement compared with the preoperative levels (all p<0.05). Moreover, no recurrence was recorded after operation.
Conclusion:
AID plus CWR is a minimally invasive and safe approach for pediatric patients with popliteal cysts to promote postoperative recovery and reduce the recurrence rate.
