| Objective: To investigate the safety and clinical efficacy of arthroscopic internal drainage of popliteal cysts and arthroscopic debridement combined with traditional posterior open surgery in the treatment of adult popliteal cysts.Methods: The clinical data of 89 patients with popliteal cysts admitted to our hospital from August 2018 to December 2019 were collected and retrospectively analyzed.All patients received MRI examination to determine the location and structure of the cyst.The Lysholm knee function score and the Rauschning and Lindgren score were applied to classify the popliteal cysts before surgery,and these scores were performed again at the end of the last follow-up postoperatively to evaluate the impact of the operation on patients’ knee joint function.Meanwhile,the surgical treatment effect was also evaluated by comparing the operation time,incision length,hospitalization time,postoperative complications,and cyst recurrence rate between the two subgroups.Results: The results of preoperative examination showed that all popliteal cyst patients had related intra-knee lesions,including synovial hyperplasia,meniscus injury,osteoarthritis,and so on.Among them,23 patients were female,and 18 patients were male.Patients with popliteal cysts were separated into two subgroups according to their surgical methods,including 23 cases in the arthroscopic surgery group(Group A)and 18 cases in the arthroscopic debridement combined with open surgery group(Group B).All patients with popliteal cysts were followed up for 9-12 months,with an average follow-up time of 9.79±2.34 months.During this period,all patients had no hematoma,neurovascular injury,incision and intra-articular infection,or other complications after arthroscopic surgery.All incisions were healed at first stage.The length of the surgical incision in Group A was(3.98±0.39)cm and the operation time was(50.83±7.76)min,which were significantly shorter than those in treatment Group B with(8.67±1.25)cm incision and(65.28±9.68)min operation time(P < 0.05).The average hospital stay of the two groups was 5.31±1.74 days for Group A and4.40±2.32 days for Group B,respectively.The length of patients’ staying time was almost the same,and the difference was not statistically significant(P> 0.05).The results of B-ultrasound examination of the patients after the operation showed that 0 cases of popliteal cyst recurrence in Group A and 1 cases of popliteal cyst recurrence in Group B.There was no significant difference in the recurrence rate of cyst between the two subgroups(P> 0.05).In terms of knee joint function,the Lysholm function score results suggest that the preoperative score of Group A patients was(63.65±14.91)points,the last follow-up after operation was(89.81±6.79)points,and the points in Group B patients were(59.19±11.61)before surgery and(89.80±6.70)in the last follow-up.The knee joint function in all patients were significantly better than before,and there was no significant difference between the two subgroups(P> 0.05).Moreover,the results of Rauschning and Lindgren’s cyst grading showed that 15 patients in Group A had Grade 0,8 patients in Grade I,and 3 patients in Grade II.Group B had 5 patients in Grade 0,5 patients in Grade I,and 5 patients in Group II.The improvement rate of patients in Group A who recovered to Grade I and above was 89%,and the improvement rate of patients in Group B was 67%.There was no significant difference between two subgroups(P> 0.05).Conclusion: Both groups of surgical methods can achieve satisfactory results in the treatment of adult popliteal cysts.However,compared with method of arthroscopic debridement combined with posterior open surgery,total arthroscopic surgery has the advantages of smaller incision and shorter operation time.Total arthroscopic surgery can treat popliteal cysts with minimal invasiveness,so it is more worthy of clinical promotion in adult popliteal cysts treatment. |
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