A comparison of clinical efficacy between different surgical approaches for popliteal cyst

BACKGROUND A popliteal cyst is a benign swelling with synovial fluid located behind the knee joint. Popliteal cysts are often asymptomatic; however, symptomatic cysts may cause pain and may need surgery interventions. Here, we performed a perspective study to compare the clinical efficacy of different surgical approaches, including traditional open excision and advanced arthroscopic treatment. METHODS A total of 76 patients with popliteal cysts were assigned into three groups by a randomized complete block design. Group A included 32 patients (15 males and 17 females, age 55.3 ± 9.8 years) who received arthroscopic internal drainage of the cysts. Group B included 19 patients (9 males and 10 females, age 55.4 ± 7.6 years) who received open excision after arthroscopic treatment. Group C included 25 patients (11 males and 14 females, age 54.2 ± 8.5 years) who received open excision. All patients were followed up for an average of 13.7 ± 2.4 months. The following parameters were compared: the time of surgery, during surgery, the length of incision, the incision healing rate, the visual analog scale (VAS) for pain, the hospitalization time, the rate of recovery to level 0-1 cysts, the recurrence rate, and the Lysholm score. RESULTS Group A exhibited significant better outcomes compared to groups B and C in the length of incision (1.6 ± 0.1 cm), the incision healing rate (100%), the postoperative VAS score (2.7 ± 1.2), the hospitalization time (7.8 ± 2.8 days), and the Lysholm score at the last follow-up (85.8 ± 5.2). The recurrence rate is significantly lower in groups A (3.1%) and B (5.2%) than group C (40%) (P < 0.001). CONCLUSIONS Arthroscopic treatment for popliteal cysts exhibited better clinical outcomes with minimal invasion and can be recommended for future clinical interventions.