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Published in: Journal of Orthopaedic Surgery and Research 1/2018

Open Access 01-12-2018 | Research article

Clinical manifestation and arthroscopic treatment of symptomatic posterior cruciate ligament cyst

Authors: Kai Tie, Hua Wang, Xinyu Zhao, Yang Tan, Jun Qin, Liaobin Chen

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2018

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Abstract

Background

Ganglion cyst of cruciate ligaments is a rare lesion; the prevalence is 0.3–0.8%. The purpose of this study was to present clinical features of symptomatic posterior cruciate ligament (PCL) cyst, introduce the arthroscopic excision technique, and evaluate the clinical outcome.

Methods

A series of 11 patients with symptomatic PCL cyst from November 2012 to December 2014 were involved in this retrospective study. Detailed medical history collecting and physical examination were conducted. Magnetic resonance imaging (MRI) scan was used to confirm the diagnosis. Arthroscopic resection was performed, and the sample of the cyst was taken for pathologic examination. The follow-up averaged 30.7 months. International Knee Documentation Committee (IKDC) score, the range of motion (ROM), and MRI evaluations were obtained pre- and postoperatively to assess the surgical outcome. SPSS software was used for statistics analysis.

Results

Eight males and 3 females with 6 left knees and 5 right knees were enrolled, the mean age was 34.4 years, and the duration of symptom was 19.0 months. All cases had a definite history of knee trauma or injury. The most common symptom was knee pain at flexion or in flexion-associated activities. MRI revealed the location and size of the cyst in each case. Pathologic examination showed the cyst wall was composed of dense fibroconnective tissue and widespread thick bundles of collagen, which is similar to the structure of ganglion cyst. At the final follow-up, MRI evaluation showed no cyst recurrence. The preoperative ROM and IKDC score were 2.3° to 108.6° and 40.5 ± 11.3, respectively, compared with the postoperative ROM and IKDC score which were 0° to 134.1° and 85.5 ± 4.8 (p < 0.05) separately.

Conclusions

We conclude that the etiology of symptomatic PCL cyst is most likely associated with trauma, pain on flexion is a typical manifestation of symptomatic PCL cyst, MRI evaluation is an ideal examination for the diagnosis, and arthroscopic resection of symptomatic PCL cysts has a good outcome with no recurrence.
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Literature
1.
go back to reference Kim RS, Kim KT, Lee JY, Lee KY. Ganglion cysts of the posterior cruciate ligament. Arthroscopy. 2003;19:E36–40.CrossRef Kim RS, Kim KT, Lee JY, Lee KY. Ganglion cysts of the posterior cruciate ligament. Arthroscopy. 2003;19:E36–40.CrossRef
2.
go back to reference Mao Y, Dong Q, Wang Y. Ganglion cysts of the cruciate ligaments: a series of 31 cases and review of the literature. BMC Musculoskelet Disord. 2012;13:137.CrossRefPubMedPubMedCentral Mao Y, Dong Q, Wang Y. Ganglion cysts of the cruciate ligaments: a series of 31 cases and review of the literature. BMC Musculoskelet Disord. 2012;13:137.CrossRefPubMedPubMedCentral
3.
go back to reference Krudwig WK, Schulte KK, Heinemann C. Intra-articular ganglion cysts of the knee joint: a report of 85 cases and review of the literature. Knee Surg Sports Traumatol Arthrosc. 2004;12:123–9.CrossRefPubMed Krudwig WK, Schulte KK, Heinemann C. Intra-articular ganglion cysts of the knee joint: a report of 85 cases and review of the literature. Knee Surg Sports Traumatol Arthrosc. 2004;12:123–9.CrossRefPubMed
4.
go back to reference Joo YB, Kim YM. Symptomatic posterior cruciate ganglion cyst causing impingement between posterior root of the medial meniscus and anterior to the posterior cruciate ligament. Knee Surg Relat Res. 2012;24:52–5.CrossRefPubMedPubMedCentral Joo YB, Kim YM. Symptomatic posterior cruciate ganglion cyst causing impingement between posterior root of the medial meniscus and anterior to the posterior cruciate ligament. Knee Surg Relat Res. 2012;24:52–5.CrossRefPubMedPubMedCentral
6.
go back to reference Lunhao B, Yu S, Jiashi W. Diagnosis and treatment of ganglion cysts of the cruciate ligaments. Arch Orthop Trauma Surg. 2011;131:1053–7.CrossRefPubMed Lunhao B, Yu S, Jiashi W. Diagnosis and treatment of ganglion cysts of the cruciate ligaments. Arch Orthop Trauma Surg. 2011;131:1053–7.CrossRefPubMed
7.
go back to reference Shetty GM, Nha KW, Patil SP, Chae DJ, Kang KH, Yoon JR, Choo SK, Yi JW, Kim JH, Baek JR. Ganglion cysts of the posterior cruciate ligament. Knee. 2008;15:325–9.CrossRefPubMed Shetty GM, Nha KW, Patil SP, Chae DJ, Kang KH, Yoon JR, Choo SK, Yi JW, Kim JH, Baek JR. Ganglion cysts of the posterior cruciate ligament. Knee. 2008;15:325–9.CrossRefPubMed
8.
go back to reference Kim MG, Kim BH, Choi JA, Lee NJ, Chung KB, Choi YS, Cho SB, Lim HC. Intra-articular ganglion cysts of the knee: clinical and MR imaging features. Eur Radiol. 2001;11:834–40.CrossRefPubMed Kim MG, Kim BH, Choi JA, Lee NJ, Chung KB, Choi YS, Cho SB, Lim HC. Intra-articular ganglion cysts of the knee: clinical and MR imaging features. Eur Radiol. 2001;11:834–40.CrossRefPubMed
9.
go back to reference Tsai TY, Yang YS, Tseng FJ, Lin KY, Liu CW, Shen HC, Lee CH, Lin LC, Pan RY. Arthroscopic excision of ganglion cysts of the posterior cruciate ligaments using posterior trans-septal portal. Arthroscopy. 2012;28:95–9.CrossRefPubMed Tsai TY, Yang YS, Tseng FJ, Lin KY, Liu CW, Shen HC, Lee CH, Lin LC, Pan RY. Arthroscopic excision of ganglion cysts of the posterior cruciate ligaments using posterior trans-septal portal. Arthroscopy. 2012;28:95–9.CrossRefPubMed
10.
go back to reference Liu SH, Osti L, Mirzayan R. Ganglion cysts of the anterior cruciate ligament: a case report and review of the literature. Arthroscopy. 1994;10:110–2.CrossRefPubMed Liu SH, Osti L, Mirzayan R. Ganglion cysts of the anterior cruciate ligament: a case report and review of the literature. Arthroscopy. 1994;10:110–2.CrossRefPubMed
11.
go back to reference McLaren DB, Buckwalter KA, Vahey TN. The prevalence and significance of cyst-like changes at the cruciate ligament attachments in the knee. Skelet Radiol. 1992;21:365–9.CrossRef McLaren DB, Buckwalter KA, Vahey TN. The prevalence and significance of cyst-like changes at the cruciate ligament attachments in the knee. Skelet Radiol. 1992;21:365–9.CrossRef
12.
go back to reference Zantop T, Rusch A, Hassenpflug J, Petersen W. Intra-articular ganglion cysts of the cruciate ligaments: case report and review of the literature. Arch Orthop Trauma Surg. 2003;123:195–8.CrossRefPubMed Zantop T, Rusch A, Hassenpflug J, Petersen W. Intra-articular ganglion cysts of the cruciate ligaments: case report and review of the literature. Arch Orthop Trauma Surg. 2003;123:195–8.CrossRefPubMed
13.
go back to reference Nam D, Macaulay A, Cross M, Shindle MK, Warren RF. Posterior cruciate ligament resection for ganglion cyst and associated ligament degeneration. Am J Orthop (Belle Mead NJ). 2011;40:E110–4. Nam D, Macaulay A, Cross M, Shindle MK, Warren RF. Posterior cruciate ligament resection for ganglion cyst and associated ligament degeneration. Am J Orthop (Belle Mead NJ). 2011;40:E110–4.
14.
go back to reference Lakdawala A, El-Zebdeh M, Ireland J. Excision of a ganglion cyst from within the posterior septum of the knee—an arthroscopic technique. Knee. 2005;12:245–7.CrossRefPubMed Lakdawala A, El-Zebdeh M, Ireland J. Excision of a ganglion cyst from within the posterior septum of the knee—an arthroscopic technique. Knee. 2005;12:245–7.CrossRefPubMed
15.
go back to reference Sarimo J, Rantanen J, Helttula I, Orava S. Intra-articular cysts and ganglia of the knee: a report of nine patients. Knee Surg Sports Traumatol Arthrosc. 2005;13:44–7.CrossRefPubMed Sarimo J, Rantanen J, Helttula I, Orava S. Intra-articular cysts and ganglia of the knee: a report of nine patients. Knee Surg Sports Traumatol Arthrosc. 2005;13:44–7.CrossRefPubMed
16.
go back to reference Hameed SA, Sujir P, Naik MA, Rao SK. Ganglion cyst of the posterior cruciate ligament in a child. Singap Med J. 2012;53:e80–2. Hameed SA, Sujir P, Naik MA, Rao SK. Ganglion cyst of the posterior cruciate ligament in a child. Singap Med J. 2012;53:e80–2.
17.
go back to reference Deutsch A, Veltri DM, Altchek DW, Potter HG, Warren RF, Wickiewicz TL. Symptomatic intraarticular ganglia of the cruciate ligaments of the knee. Arthroscopy. 1994;10:219–23.CrossRefPubMed Deutsch A, Veltri DM, Altchek DW, Potter HG, Warren RF, Wickiewicz TL. Symptomatic intraarticular ganglia of the cruciate ligaments of the knee. Arthroscopy. 1994;10:219–23.CrossRefPubMed
18.
go back to reference Bui-Mansfield LT, Youngberg RA. Intraarticular ganglia of the knee: prevalence, presentation, etiology, and management. AJR Am J Roentgenol. 1997;168:123–7.CrossRefPubMed Bui-Mansfield LT, Youngberg RA. Intraarticular ganglia of the knee: prevalence, presentation, etiology, and management. AJR Am J Roentgenol. 1997;168:123–7.CrossRefPubMed
19.
go back to reference Sundaram M, McGuire MH, Fletcher J, Wolverson MK, Heiberg E, Shields JB. Magnetic resonance imaging of lesions of synovial origin. Skelet Radiol. 1986;15:110–6.CrossRef Sundaram M, McGuire MH, Fletcher J, Wolverson MK, Heiberg E, Shields JB. Magnetic resonance imaging of lesions of synovial origin. Skelet Radiol. 1986;15:110–6.CrossRef
20.
go back to reference Hammer DS, Dienst M, Kohn DM. Arthroscopic treatment of tumor-like lesions of the knee joint: localized pigmented villonodular synovitis and ganglion cysts of the anterior cruciate ligament. Arthroscopy. 2001;17:320–3.CrossRefPubMed Hammer DS, Dienst M, Kohn DM. Arthroscopic treatment of tumor-like lesions of the knee joint: localized pigmented villonodular synovitis and ganglion cysts of the anterior cruciate ligament. Arthroscopy. 2001;17:320–3.CrossRefPubMed
21.
go back to reference Burk DL Jr, Dalinka MK, Kanal E, Schiebler ML, Cohen EK, Prorok RJ, Gefter WB, Kressel HY. Meniscal and ganglion cysts of the knee: MR evaluation. Am J Radiol. 1988;150:331–6.  Burk DL Jr, Dalinka MK, Kanal E, Schiebler ML, Cohen EK, Prorok RJ, Gefter WB, Kressel HY. Meniscal and ganglion cysts of the knee: MR evaluation. Am J Radiol. 1988;150:331–6.
22.
go back to reference Kang CN, Kim DW, Kim DJ, Kim SJ. Intra-articular ganglion cysts of the knee. Arthroscopy. 1999;15:373–8.CrossRefPubMed Kang CN, Kim DW, Kim DJ, Kim SJ. Intra-articular ganglion cysts of the knee. Arthroscopy. 1999;15:373–8.CrossRefPubMed
23.
go back to reference Derman P, Kamath AF, Kelly IJ. Ganglion cysts of the posterior cruciate ligament. Am J Orthop (Belle Mead NJ). 2011;40:257–8. Derman P, Kamath AF, Kelly IJ. Ganglion cysts of the posterior cruciate ligament. Am J Orthop (Belle Mead NJ). 2011;40:257–8.
24.
go back to reference Dinakar B, Khan T, Kumar AC, Kumar A. Ganglion cyst of the anterior cruciate ligament: a case report. J Orthop Surg (Hong Kong). 2005;13:181–5.CrossRef Dinakar B, Khan T, Kumar AC, Kumar A. Ganglion cyst of the anterior cruciate ligament: a case report. J Orthop Surg (Hong Kong). 2005;13:181–5.CrossRef
Metadata
Title
Clinical manifestation and arthroscopic treatment of symptomatic posterior cruciate ligament cyst
Authors
Kai Tie
Hua Wang
Xinyu Zhao
Yang Tan
Jun Qin
Liaobin Chen
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Journal of Orthopaedic Surgery and Research / Issue 1/2018
Electronic ISSN: 1749-799X
DOI
https://doi.org/10.1186/s13018-018-0798-x

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