Arthroscopic Decompression and Shaving of Popliteal Cyst Using Posteromedial Portal: Technical Note

Ahn, Jin Hwan; Cho, Yong Jin; Ko, Sang Hun; Park, Jun Sik; Kim, Hyo Kon

Abstract

PURPOSE: To present the surgical procedure of arthroscopic decompression and shaving of popliteal cyst using posteromedial portal. OPERATIVE TECHNIQUE: After diagnostic knee arthroscopic examination, if there is associated intra-articular pathology with popliteal cyst, appropriate arthroscopic procedure has to be performed to adress the associated intra-articular pathology. It is the most important procedure to find the opening of connection between joint cavity and popliteal cyst at posteromedial compartment using anterolateral or posteromedial In some cases the capsular fold overlie the opening of connection, so thorough diagnostic examnation is mandatory. When the opening of connection is visualized, it is enlarged about 8 mm by the arthroscopic decompressive procedure of popliteal cyst using arthroscopic shaver which is approached via the posteromedial portal. After then arthroscope is positioned at posteromedial portal and advanced into popliteal cyst via enlarged opening to visualize the inside of popliteal cyst. While visualizing the inside of popliteal cyst, a 18 gauge spinal needle is introduced by outside-in technique from medial side of the skin overlying popliteal cyst. And then we make trans-cystic portal at the site of spinal needle by incising the skin with # 11 blade and arthroscopic shaver is introduced within popliteal cyst via trans-cystic portal, and arthroscopic cystectomy is performed to shave the inner wall of popliteal cyst with arthroscopic shaver. DISCUSSION: The arthroscopic procedure for popliteal cyst is an alternative of traditional surgical removal of popliteal cyst and it is expected to diagnose and to manage associated intra-articular pathology and to perform arthroscopic decompression and cystectomy effectively using posteromedial portal.