背景:在以前的研究中,在关节镜下治疗pop囊肿和伴随的关节内病理后,已经报道了良好的结果。然而,仅有少数研究报道了与残余pop囊肿相关的因素。本研究的目的是检查临床和影像学结果,并探讨关节镜下囊肿减压术和囊肿壁切除术后与the囊肿复发有关的因素。
目的:作者假设关节镜下减压和膀胱切除术后残留的the囊肿与退行性软骨病变有关。
方法:2010年12月至2018年12月,对54例pop囊肿患者进行关节镜下减压和通过后内侧囊性门切除囊壁。使用磁共振成像(MRI)或超声检查观察the囊肿是否消失或减少。术后测量the囊肿的最大直径。根据治疗结果将患者分为消失组和减少组。年龄,性别,症状持续时间,基于Kellgren-Lawrence(K-L)分级的术前退行性改变,根据国际软骨修复协会(ICRS)的等级,滑膜炎,功能结果,比较两组患者关节内病变情况。根据Rauschning和Lindgren膝关节评分评估功能结果。这项研究包括22名男性和32名女性,平均年龄49.6岁(范围,5-82岁)。根据ICRS等级系统,28例(51.8%)患者为0至II级,26例(48.2%)患者为III至IV级。
结果:随访影像学评估显示,20例(37%)囊肿完全消失,34例(63%)囊肿缩小。平均囊肿大小从5.7cm明显减小(范围,1.7-15cm)至1.7cm(范围,0-6.4cm),Rauschning和Lindgren膝关节评分显示所有患者的临床特征均得到改善。在消失和减少的群体之间,退行性软骨损伤的存在(p=0.022,比值比8.702,95%置信区间:1.368-55.362)显示出统计学上的显著差异。
结论:通过后内侧囊性门静脉,大约40%的患者囊肿被完全切除,60%的患者尺寸缩小。退行性软骨病变的存在是残余pop囊肿的相关危险因素。这些发现可能有助于确保解释不良预后因素。
方法:IIIb;回顾性队列研究。
In previous studies, good results have been reported after arthroscopic treatment of popliteal cysts and concomitant intra-articular pathology. However, only a few studies have reported the associated factors with residual popliteal cysts. The aim of this study was to examine the clinical and radiographic outcomes and investigate the factors associated with the recurrence of popliteal cyst after arthroscopic cyst decompression and cyst wall resection.
The authors hypothesized that residual popliteal cyst after arthroscopic decompression and cystectomy would be associated with degenerative cartilage lesions.
From December 2010 to December 2018, 54 patients with popliteal cysts were treated with arthroscopic decompression and cyst wall resection through an additional posteromedial cystic portal. Magnetic resonance imaging (MRI) or ultrasonography was used to observe whether the popliteal cyst had disappeared or decreased. The maximum diameter of the popliteal cyst was measured after surgery. The patients were classified into the disappeared and reduced groups according to the treatment outcome. Age, sex, symptom duration, preoperative degenerative changes based on the Kellgren-Lawrence (K-L) grade, cartilage lesions according to the International Cartilage Repair Society (ICRS) grades, synovitis, functional outcomes, and associated intra-articular lesions were compared between the two groups. The functional outcome was evaluated on the basis of the Rauschning and Lindgren knee score. The study included 22 men and 32 women, with mean age of 49.6 years (range, 5-82 years). According to the ICRS grade system, 28 (51.8%) patients had grade 0 to II, 26 (48.2%) patients had grade III to IV.
Follow-up radiographic evaluation revealed that the cyst had completely disappeared in 20 patients (37%) and reduced in size in 34 (63%). The mean cyst size was decreased significantly from 5.7cm (range, 1.7-15cm) to 1.7cm (range, 0-6.4cm), and the Rauschning and Lindgren knee score showed improved clinical features in all the patients. Between the disappeared and reduced groups, the presence of degenerative cartilage lesions (p=0.022, odds ratio 8.702, 95% confidence interval: 1.368-55.362) showed statistically significant differences.
Through the posteromedial cystic portal, cysts were completely removed in approximately 40% of patients, and the size was reduced in 60% of patients. Presence of degenerative cartilage lesion represents an associated risk factor for residual popliteal cyst. These findings could be helpful in ensuring explaining poor prognostic factors.
IIIb; retrospective cohort study.