Arthroscopic management lateral meniscal cysts: about 105 cysts with 5 years of follow-up (original) (raw)
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Arthroscopic treatment of 105 lateral meniscal cysts with 5-year average follow-up
Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2004
To evaluate meniscal damage and the midterm clinical outcome, we performed a retrospective review of 105 lateral meniscal cysts that were treated arthroscopically at our institution. Type of Study: Retrospective review. Methods: From a series of 8,100 knee arthroscopies, 122 patients (1.5%) with 124 lateral meniscal cysts were selected. Eight of the patients were lost to follow-up and 11 patients had associated pathology; therefore, 105 lateral meniscal cysts on stable knees were included in this study. Average follow-up was 5 years (range, 1 to 12.5 years). The mean age was 33 years (range, 12 to 69 years). All patients had presented with tenderness over the joint line with a palpable mass. All cases were treated arthroscopically and all patients underwent a complete physical examination before surgery and at last follow-up. Radiographic evaluation was available at final follow-up for 68 cases. Results: All patients had a meniscal tear at the time of surgery and 60 (57%) had a horizontal cleavage component. For meniscal tears, arthroscopic partial lateral meniscectomy was performed in 104 cases and meniscal repair in 1 case. For cysts, intra-articular debridement was performed in 91 cases and open cystectomy in 14. Eleven cysts recurred and a second arthroscopy was required. The clinical results, including those cases with recurrent cysts, were excellent or good in 87% of cases. Osteoarthritis following treatment for meniscal cysts occurred in 9% of cases. Conclusions: When there was a cyst and no other intra-articular damage, the prognosis was excellent. For lateral meniscal cysts, arthroscopic partial meniscectomy with intra-articular debridement yields predictable results. Level of Evidence: Level IV.
Meniscal Repair and Parameniscal Cyst Excision with Knee Arthroscopic Surgery: A Case Report
https://www.ijhsr.org/IJHSR\_Vol.11\_Issue.10\_Oct2021/IJHSR-Abstract.022.html, 2021
Background: Meniscal cysts were rare case. There's a 50 to 100% chance forming cyst to the tear if there was an injury happens. Trauma would cause tears happen in meniscus, leads to formation of hemorrhage which formed mucoid degeneration. The necrosis happens locally plus degeneration of mucoid forming a cyst. Thus, the meniscal cysts challenge the clinician to have clinical reasoning so then the patient can get accurate diagnosis and preferred management. Method: This paper is a case report of surgery on a patient present with cysts on lateral para meniscus which done arthroscopically with all inside technique. Results: The procedure which done by arthroscope and motorized shaver had a great outcome in this patient which were analyze from Visual Analog Scale (VAS) and Western Ontario and McMaster Index (WOMAC) 3 months after the procedure, and reach VAS score of 2/10 which was mild pain and 59,8 in WOMAC score. Conclusion: The arthroscopy and all inside technique with motorized shaver is a choice of lateral para meniscal cysts surgery with good results to be considered by orthopedic surgeons.
International Orthopaedics, 2019
Introduction The aim of this study was to describe clinical and radiological long-term results of an arthroscopic partial meniscectomy associated with an outside-in decompressive needling of the cyst for lateral parameniscal cyst. Methods Eighteen patients with symptomatic parameniscal cysts treated between April 2002 and September 2009 were retrospectively included in the study. All patients underwent arthroscopic partial meniscectomy (preserving peripheral rim) and needling of the cyst using a 20-gauge needle. Pre-and post-operative IKDC, Tegner, and Lysholm scores were used to evaluate clinical results. Radiological results were obtained from pre-and post-operative radiographies and post-operative MRI scans. Both supine and weight bearing MRI examinations were performed. Kellgren-Lawrence and WORMS scales were used to evaluate osteoarthritis development of the knee. Results The mean follow-up period was 11.6 ± 2.6 years (range 7-15). Horizontal lesions were found in 56% of patients. All patients fully recovered. Mean Lysholm scores passed from mean pre-operative value 52 ± 16.9 to post-operative 85 ± 11.9 (P < 0.01) and mean IKDC scale score changed from 49.5 ± 14.7 to 67 ± 23.5 (P < 0.01). Mean Tegner scores did not change significantly. Post-operative radiographies showed a Kellgren-Lawrence scale grade 0 in six patients (33%), a grade I in eight (44%), a grade II in three (17%), and a grade III in one patient (6%). No patients were found with a Kellgren-Lawrence scale grade IV. No significant differences with pre-operative radiographies were found (chi-square = 1.867; df = 3; P = 0.60) in osteoarthritis development of the knee. Reported WORMS scores had an average of 12.4 ± 5.1. No recurrence of any cysts was observed. Discussion Different treatments for lateral meniscal cysts have been proposed, but proper management of the cyst is still controversial. The results of this study suggest that the outside-in needling of the cyst associated with partial meniscectomy is a highly effective, simple, and repeatable technique. Excellent clinical outcomes were reported at a mean follow-up of 11.6 ± 2.6 years (range 7-15). Imaging evaluation showed no significant evolution to osteoarthritis of the knee. Conclusions Partial arthroscopic meniscectomy associated with percutaneous decompressive needling of the cyst wall under arthroscopic visualization showed positive clinical and radiological long-term results. Neither traditional radiographies nor innovative standing MRIs showed findings of osteoarthritis.
Arthroscopy, 2003
Our goal was to compare results of partial medial arthroscopic meniscectomy with results of partial lateral arthroscopic meniscectomy and to determine prognostic factors. Type of Study: Retrospective comparative study with statistical analysis. Methods: In this study, 362 medial and 109 lateral isolated arthroscopic meniscectomies are presented with a minimum follow-up time of 10 years. All knees were stable with no previous surgery or traumatic lesion. Results: In this study, 95% of the patients were very satisfied or satisfied with the results of the medial meniscectomy, and 95.5% with results of the lateral meniscectomy (P ϭ .32). According to grades 1 and 2 of the Intenational Knee Documentation Committee (IKDC) form, 85.8% of the medial meniscectomy group were free of any symptoms, as were 79.7% of the lateral meniscectomy group (P ϭ .11). Radiologic changes after medial and lateral meniscectomy were found in 21.5% and 37.5%, respectively (P ϭ .11). The rates of radiologic changes in patients in whom the contralateral knee was radiologically normal were 22.3% and 39%, respectively (P ϭ .016). The rate of repeat surgeries for osteoarthritis was less than 0.2%. Conclusions: Subjective and clinical results after medial or lateral meniscectomy are quite similar, but radiologic results are significantly worse after lateral meniscectomy. The most accurate way to determine the degeneration caused by the meniscectomy is to evaluate joint space narrowing in patients in whom the contralateral knee was radiologically normal. Otherwise, partial medial or lateral meniscectomy are well tolerated. A better prognosis can be predicted for a patient with an isolated medial meniscal tear with one or more of the following factors: age less than 35 years, a vertical tear, no cartilage damage, and an intact meniscal rim at the end of the meniscectomy. With an isolated lateral meniscal tear, a better prognosis can be predicted if the patient is young and has an intact meniscal rim at the end of the meniscectomy.
Medial meniscus anterior horn cyst: arthroscopic decompression
Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2004
Meniscus cysts are mostly seen with meniscus tears, and arthroscopic decompression of cysts is gaining great importance in their treatment. In this study, we present a medial meniscus anterior horn cyst without an accompanying tear in the meniscus. A 33-year-old male patient was seen with pain and a palpable mass in his right knee. He complained that the severity of the pain had increased over the previous year. After the clinical and radiologic examinations, a painless, fixed soft tissue mass averaging 4 ϫ 5 cm was located just medial to tuberositas tibia. The cyst was decompressed arthroscopically. In the 18th month of follow up, the mass had totally disappeared and the patient had no pain. Medial meniscus cysts are seen nine times fewer than lateral meniscus cysts. They are mostly accompanied with meniscal tears. Total meniscectomy with arthrotomy, isolated cyst excision, cyst excision, and partial meniscectomy with arthrotomy and arthroscopic partial meniscectomy with cyst decompression are treatment modalities. Arthroscopic meniscal cyst decompression is an important treatment choice and should always be taken into consideration with low morbidity, short recovery period, low recurrrence rate, preservation of range of motion, and permission for early mobilization and rehabilitation of the joint.
Comparison of clinical and arthroscopic findings in meniscaltears
Introduction: This study was conducted to compare the clinical and arthroscopic findings in lateral and medial meniscal tear injuries in order to assess the diagnostic significance of the clinical examinations findings. Patients and methods: All patients attending our clinic with knee pain from2009. to 2013. underwent systematic and thorough clinical assessment. From one hundred and three patients with knee problems in 40 were diagnosed LM (lateral meniscus) tears and in 45 MM (medial meniscus) tears arthroscopically. In this study meniscal tears were clinically diagnosed by positive McMurray and Apley test. All clinically diagnosed patients underwent diagnostic and therapeutic knee arthroscopy to assess the accuracy of clinical diagnosis. The accuracy, PPV, NPV, sensitivity and specificity were calculated based on clinical examinations and arthroscopic findings. Results: Identification of meniscal tears in our study was presented with 85% accuracy of 'McMurray' clinical examination test for LM tears and 80% accuracy for the MM tears, and for 'Apley' clinical examination test for LM tears was obtained with 73% accuracy and 63% accuracy for MM tears. Conclusion: According to our findings we can conclude that McMurry clinical examination test is more accurate for predicting i.e. diagnosing of meniscal tears. Contrary, Apley clinical examination test showed less accuracy for predicting i.e. diagnosing of meniscal tears.
JBJS Case Connector, 2020
Case: We report a 39-year-old man who presented with a painful mass that had been growing over the anteromedial aspect of his left leg for 2 years and was recurrent after an open excisional biopsy. Magnetic resonance imaging showed a lobulated cyst that extended from the medial meniscus. Arthroscopic cyst decompression, anterior cruciate ligament reconstruction, partial meniscectomy, and repair of the meniscotibial capsule were performed. There was no recurrence during the 1-year follow-up. Conclusions: Arthroscopic cyst decompression and repair of the posterior meniscotibial capsule is a good and safe alternative procedure for the treatment of large-sized meniscal cysts with distal extensions. NOTE: The authors gratefully acknowledge Mr. Wacharapol Tepa for data collection, Miss. Waraporn Chalermsuk and Ms. Kawitsara Eumbunnapong for graphic materials.