Summary

We report 90-day outcomes of parameniscal and popliteal cyst excision.

Abstract

Title: Early Complications Following Open Parameniscal and Popliteal Cyst Excision of the Knee

Introduction

Parameniscal and popliteal cysts are relatively common lesions in the knee that may cause pain and exert mass effect on the surrounding periarticular structures. For large symptomatic cysts, surgical excision is frequently performed in persistently symptomatic patients who fail conservative management. The incidence of postoperative complications following open cyst excision has not been well described. Thus, this study aimed to quantify the incidence of 90-day postoperative complications following open excision of parameniscal and popliteal cysts using a large global multicenter database.

Methods

A retrospective cohort study was performed using the TriNetX (Cambridge, MA), a global research network that includes research data from more than 70 healthcare organizations across 4 countries. Patients who underwent parameniscal or popliteal cyst excision within the last 20 years (2004 to 2024) were identified using CPT codes 27347 (parameniscal) and 27345 (popliteal). The incidence of early postoperative complications, including infection, deep vein thrombosis (DVT), nerve injury, and need for reoperation, was queried within 90 days following surgery. Data on concomitant knee arthroscopy and associated procedures was also collected.

Results

A total of 2,612 patients who underwent parameniscal (44.9%) and popliteal (55.1%) cyst excision were identified. Of these patients, 58 (2.2%) developed a postoperative infection, 43 (1.6%) experienced a DVT, 10 (0.4%) suffered from a nerve injury, and 37 (1.4%) required reoperation. Additionally, 1,228 (52%) underwent concomitant knee arthroscopy with an open cyst excision. The most common concomitant arthroscopic procedures were meniscectomy (35%), meniscus repair (6%), synovectomy (7%), chondroplasty (6%), and abrasion arthroplasty (2%).

Conclusion

Although these findings highlight the relatively low complications following open cyst excision of the knee, the rates of postoperative infection and DVT after open cyst excision are higher those reported after isolated knee arthroscopy. Understanding of the short-term complication rates after open parameniscal and popliteal cyst excision can aid surgeons in the preoperative counselling of patients considering such procedures.