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Arthroscopic Treatment of Meniscal Cysts and Clinical Follow Up

Arthroscopic Treatment of Meniscal Cysts and Clinical Follow Up

Sang Hak Lee, MD, PhD, KOREA, REPUBLIC OF Tae Wook Kim, MD, KOREA, REPUBLIC OF Bo Seung Bae, MD, KOREA, REPUBLIC OF Jun Bum Park, MD, KOREA, REPUBLIC OF Min-Gyu Kim, MD, KOREA, REPUBLIC OF

Kyung Hee University Hospital at Gangdong, Seoul, Seoul, KOREA, REPUBLIC OF


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Anatomic Location

Anatomic Structure

Diagnosis / Condition

Treatment / Technique

Patient Populations

Diagnosis Method

MRI

Sports Medicine


Summary: Arthroscopic meniscectomy or repair, with cyst decompression, was effective in treating horizontal cleavage meniscal tears with meniscal cysts.


Background

Meniscal cysts are related to horizontal cleavage tears of the adjacent meniscus. Numerous treatments about meniscal cysts combined with meniscal tears have been reported.

Purpose

The purpose of this study was to investigate the location and size of meniscal cysts in patients who had arthroscopic surgery of horizontal cleavage meniscal tears and to analyze the clinical outcomes of arthroscopic treatment.

Methods

A total of 73 meniscal cysts in 65 knees treated with arthroscopic surgery from June 2011 to August 2021 were examined. The knees which had meniscal cysts with meniscal tears in preoperative Magnetic Resonance Imaging (MRI) and underwent arthroscopic surgery (meniscectomy, repair) with cyst decompression were included. The size, location, and tear patterns of meniscal cysts at preoperative MRI and arthroscopy were analyzed. Patients had a minimum of 1-year clinical follow-up. Tegner score, Lysholm knee score, and Hospital for Special Surgery (HSS) score were applied to evaluate the clinical outcomes.

Results

Meniscal cysts were found approximately at a 1:1 medial meniscus (MM) to lateral meniscus (LM) ratio. For the group of meniscal cysts in the MM, 78.9% (30/38) of meniscal cysts were located at the area around the posterior horn of the MM. 91.4% (32/35) of the meniscal cysts at the LM were found around the anterior horn or the midbody of the LM. The Tegner score (from 2.75 ± 1.03 to 4.09 ± 1.38), Lysholm knee score (from 69.14 ± 14.46 to 88.69 ± 7.97), and HSS score (from 81.57 ± 9.47 to 95.45 ± 4.73) were all significantly increased after arthroscopic surgery with cyst decompression. The clinical outcomes of the patients who underwent arthroscopic meniscectomy and arthroscopic repair showed no significant statistical difference. After cyst decompression arthroscopic surgery, 80.0% of all meniscal cysts (32/40) were completely removed on postoperative MRI. 87.5% (7/8) of incompletely removed cysts were larger than 20mm on preoperative MRI. There was no significant difference in the laterality between large cysts (>20mm) and cysts (<20mm). Two cases lead to additional re-operations.

Conclusion

Arthroscopic meniscectomy or repair, with cyst decompression, was effective in treating horizontal cleavage meniscal tears with meniscal cysts. No significant clinical difference was found between the results of the two arthroscopic surgeries. In addition, the size of the cyst measured on preoperative MRI had a significant effect on the complete removal status.


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