Arthroscopic excision of ganglion cysts of the posterior cruciate ligaments using posterior trans-septal portal.
OBJECTIVE
To evaluate clinical outcomes of arthroscopic excision of ganglion cysts involving the posterior cruciate ligament (PCL) using the posterior trans-septal portal in the knee.


METHODS
A retrospective study was performed of 15 cases of ganglion cyst involving the PCL treated at our institution over a period of 4 years. All the cysts were diagnosed and had their location confirmed preoperatively by magnetic resonance imaging (MRI). All the cysts were excised arthroscopically through the posterior trans-septal portal. All patients were followed up with MRI evaluation at a mean of 36 months after surgery. In addition, International Knee Documentation Committee (IKDC) scores and range of motion (ROM) were obtained preoperatively and postoperatively simultaneously with MRI to assess the surgical outcomes.


RESULTS
Most of the patients were male patients, and the mean age was 32 years. The most common presenting complaint was pain and difficulty in knee flexion. Preoperatively, the mean ROM was 3° to 110° and the mean IKDC score was 53 (range, 38 to 67; SD, 7.9). The location of the main cystic component was posterior to the PCL in 14 patients (93%) and anterior to the PCL in 1 patient (7%). After surgery, MRI evaluation at a mean follow-up time of 36 months showed no cyst recurrence. Postoperatively, the mean IKDC score was 91 (range, 70 to 99; SD, 9.3) and the mean ROM was 3° to 128°.


CONCLUSIONS
Ganglion cysts associated with the PCL can cause knee pain and limitation of knee flexion. MRI evaluation is a noninvasive method of diagnosing PCL ganglion cysts. Arthroscopic excision through the posterior trans-septal portal is a good option for relieving pain and preventing cyst recurrence.


METHODS
Level IV, therapeutic case series.
Department of Orthopedics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Tsung-Ying
TY
Tsai
Yu-Sheng
YS
Yang
Feng-Jen
FJ
Tseng
Kun-Yi
KY
Lin
Che-Wei
CW
Liu
Hsain-Chung
HC
Shen
Chian-Her
CH
Lee
Leou-Chyr
LC
Lin
Ru-Yu
RY
Pan
D000293:Adolescent; D000328:Adult; D020679:Arthroscopes; D001182:Arthroscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D045888:Ganglion Cysts / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D016119:Posterior Cruciate Ligament / Q000473:pathology / Q000601:surgery*; D016059:Range of Motion, Articular / Q000502:physiology*; D020127:Recovery of Function; D012189:Retrospective Studies; D018570:Risk Assessment; D012494:Sampling Studies; D016896:Treatment Outcome; D055815:Young Adult