Popliteal cystoscopic excisional debridement and removal of capsular fold of valvular mechanism of large recurrent popliteal cyst

Purpose: The purpose of this study was to evaluate the effectiveness of cystoscopic excisional debridement and removal of unilateral flow of the capsular fold of valvular mechanism in the posteromedial corner of the recurrent popliteal cyst. Type of Study: Retrospective review. Methods: From March 1998 to May 2000, we treated 14 cases of popliteal cyst by cystoscopic excisional debridement. The cysts were relatively large cysts, about 5 cm in diameter on sonography. Conservative treatment for about 1 year, with about 3 aspirations failed. The mean follow-up duration was 29.7 (24 to 36) months. We used Rauschning and Lindgren criteria for evaluations. We estimated surgical time. Patients underwent sonography 6 months and I year after surgery. Pain, range of motion. and recurrence were checked I year after surgery. Results: The average surgical time was 45 (31 to 58) minutes. The time to pain elimination and full range of motion was I or 2 days after surgery. No recurrence was noted in any patients. At the last follow-up, patients reported no discomfort or pain, and all had free range of motion. Preoperatively, Rauschning and Lindgren criteria were grade 0 in 0 cases; grade I in 3 cases; grade 2 in 10 cases; and grade 3 in I case. At 2 weeks after surgery, criteria were grade 0 in 13 cases and grade I in I case; at final follow-up evaluation, all were grade 0. Hematoma occurred in I case. However, in cases lost to follow-up and in short-term follow-up cases, technical errors occurred: not entering within the cyst in 2 cases, extravasion in I case, and recurrence in I case. Conclusions: A popliteal cystoscopic excisional debridement by motorized shaver and removal of the capsular fold of the valvular mechanism is an effective alternative to the open technique of treating popliteal cysts.