An Effective Surgical Strategy for Anteromedial Osteoarthritis of the Knee with Simultaneous Popliteal Cysts Drainage

Summary

Popliteal cysts are frequently found during the pre-operative examination of patients with osteoarthritis being prepared for the unicompartmental knee arthroplasty. These symptomatic cysts usually require treatment. To do this, a unicompartmental knee arthroplasty was performed with internal drainage of the popliteal cyst under the same anesthetic.

Abstract

Unicompartmental knee arthroplasty (UKA) is an established treatment option for anteromedial osteoarthritis, and popliteal cysts are a common finding in the knee among patients with chronic osteoarthritis pain. The two are so closely related that popliteal cysts are commonly discovered during the unicompartmental knee arthroplasty preoperative examination. However, only a few reports exist on the management and outcome of popliteal cysts in the patients receiving UKA for knee osteoarthritis (OA) and popliteal cysts. As such, it is crucial to evaluate different treatment strategies and their management of popliteal cysts. In this paper, we evaluate a surgical strategy for patients with knee anteromedial osteoarthritis and symptomatic popliteal cysts. These patients were treated with UKA and internal drainage of the popliteal cyst. The results shown here, spanning 1-year post-operation follow-up, demonstrated that UKA and internal drainage is an effective surgical protocol for treating anteromedial osteoarthritis with symptomatic popliteal cysts.

Introduction

A popliteal cyst is a mass located in the popliteal area, filled with fluid, which is prevalent in locations of intra-articular lesions of the knee¹. Multiple reports suggest a strong correlation between popliteal cysts and knee osteoarthritis (OA)^2,3. As a result, ~20%-42% of patients with knee OA also experience popliteal cysts^{1,3,4,5,6,7,8}. Most of the c....

Protocol

The present study was approved by the ethics committee of Second Hospital of Shanxi Medical University and all the patients provided written informed consent.

1. Inclusion and exclusion criteria for patients

1. Use the following inclusion criteria.
   1. Select patients diagnosed with anteromedial osteoarthritis of the knee where conservative treatment failed. Diagnose anteromedial osteoarthritis of the knee by anteroposterior x-ray, based on a narrowed medial compartment of the knee but a normal lateral compartment.
   2. Verify the presence of an intact anterior cruciate ligament using clinical and int....

Results

Clinical evaluation
Each patient was followed up for at least 1 year after the operation. At 1 year postoperatively, the postoperative VAS score significantly decreased from 7.0 ± 0.9 to 0.6 ± 0.7 (P < 0.05); the HSS score improved from 48.3 ± 8.5 preoperatively to 87.8 ± 4.6 (P < 0.05); and the WOMAC score decreased from 56.0 ± 9.6 preoperatively to 11.6 ± 5.0 (P < 0.05). The symptoms of popliteal cysts were instantly relieved for all the eight patients after recovery from anesthesia. Six p.......

Discussion

A popliteal cyst, otherwise known as a Baker's cyst, is the knee joint disorder that is prevalent among the middle-aged and older population^16,17. The incidence of popliteal cysts, in combination with symptomatic knee joint disease, is between 9.2% to 38%, depending on the location and the analysis^18,19,20. Approximately 20%-42% of the patients with knee OA also have.......

Materials

List of materials used in this article

Name	Company	Catalog Number	Comments
Excel	Microsoft		digital table software
Magnetic resonance inspection (MRI)	General Electric Company		Imaging examination of popliteal cyst before and after surgery.
Oxford® Partial Knee surgery system	ZIMMER BIOMET	NONE	For the catalog numbers refer to Oxford Partial Knee Microplasty Instrumentation (femoral component, tibial component, meniscus bearing)
ultrasound	General Electric Company		we used ultrasound to observe changes in the postoperative cysts