Arthroscopic Intrameniscal Decompression for the Treatment of Lateral Meniscal Cysts

The meniscal cyst is a common complication associated with complex degenerative meniscal tears such as degenerative flaps and horizontal cleavage tears. The current gold standard treatment for this condition is arthroscopic decompression with partial meniscectomy; however, there are three concerns regarding this treatment. First, cases of meniscal cysts commonly involve an intrameniscal location of the degenerative lesion. Second, when there is difficulty in finding the lesion, a so-called "check-valve" is required, and a large-scale meniscectomy is necessary. Thus, postoperative osteoarthritis is a well-known sequela. Third, treatment of a meniscal cyst from the inner edge of the meniscus is indirect and inadequate for reaching the pathological region, as most meniscal cysts are located at the peripheral portion of the meniscus. Therefore, this report describes direct decompression of a large lateral meniscal cyst and repair of the meniscus using decompression with an intrameniscal approach. This technique is simple and reasonable for the purpose of meniscal preservation.