title: [Arthroscopic treatment of popliteal cyst excision in combination with debridement of the knee under local anesthesia].
abstract: OBJECTIVE
  To evaluate the arthroscopic treatment effectiveness of popliteal cyst excision in combination with debridement of the knee under local anesthesia by comparing with continuous epidural anesthesia.
  
  
  METHODS
  Between June 2002 and January 2013, 145 patients with popliteal cyst underwent arthroscopic popliteal cyst excision in combination with debridement of the knee under local anesthesia (local anesthesia group). In addition, 51 patients with popliteal cyst were treated with the same surgery under continuous epidural anesthesia between February 2000 and August 2005 served as control group. No significant difference was found in gender, age, side, disease duration, or cyst size between 2 groups (P > 0.05). Then, anesthesia time, analgesia effect, anesthesia satisfaction, operation time, bleeding volume, and anesthesia complication were compared between 2 groups. The guidelines of Rauschning and Lindgren were used to assess the effectiveness, and recurrence rate was recorded. Results All incisions healed primarily, no neurological or vascular injury was found. The patients were followed up 1 year and 1 month to 8 years (mean, 3.7 years) in local anesthesia group, and 8 years to 13 years and 7 months (mean, 10.8 years) in control group. Local anesthesia group had shorter anesthesia time, higher visual analogue scale (VAS) score, shorter operation time, and lower bleeding volume (P < 0.05) than control group. Anesthesia satisfaction was reduced in local anesthesia group, but there was no significant difference (χ2 = 0.071, P = 1.000). The anesthesia complication incidence of control group (15.7%, 8/51) was significantly higher than that of local anesthesia group (0) (P = 0.000). Recurrence was found in 12 patients of local anesthesia group (curative ratio 9.7%) and in 5 patients of control group (curative ratio 90.2%), showing no significant difference (χ2 = 0.111, P = 0.774). According to the guidelines of Rauschning and Lindgren, there were 131 cases of grade 0, 13 cases of grade I, and 1 case of grade II in local anesthesia group, and 37 cases of grade 0, 12 cases of grade I, and 2 cases of grade II in control group; significant differences in grading were shown between at pre- and post-operation in 2 groups (Z = -10.683, P = 0.000; Z = -6.385, P = 0.000), and between 2 groups at post-operation (Z = -3.145, P = 0.002).
  
  
  CONCLUSIONS
  Compared with under continuous epidural anesthesia, arthroscopic treatment of popliteal cyst excision under local anesthesia can obtain better results. Under local anesthesia, the condition of nerve and vessel can be timely and dynamically observed. Arthroscopic treatment of popliteal cyst excision in combination with debridement of the knee has the advantages of less trauma, lower recurrence rate, and satisfactory results.
authors.forename: Jiangtao
authors.initials: J
authors.lastname: Wang
authors.forename: Yujie
authors.initials: Y
authors.lastname: Liu
authors.forename: Junliang
authors.initials: J
authors.lastname: Wang
authors.forename: Wei
authors.initials: W
authors.lastname: Qi
authors.forename: Feng
authors.initials: F
authors.lastname: Qu
authors.forename: Xuezhen
authors.initials: X
authors.lastname: Shen
authors.forename: Gang
authors.initials: G
authors.lastname: Zhao
authors.forename: Bangtuo
authors.initials: B
authors.lastname: Yuan
authors.forename: Yang
authors.initials: Y
authors.lastname: Liu
authors.forename: Juanli
authors.initials: J
authors.lastname: Zhu
mesh_terms: D000772:Anesthesia, Local; D001182:Arthroscopy / Q000379:methods*; D003646:Debridement / Q000379:methods; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D009364:Neoplasm Recurrence, Local; D061646:Operative Time; D011151:Popliteal Cyst / Q000601:surgery*; D011184:Postoperative Period; D016896:Treatment Outcome