Should children's popliteal cyst be operated?

Popliteal cyst, often manifested as a lump at the posterior popliteal fossa of the knee joint, feels soft and sexy. The cyst is obvious when the knee joint is extended, and the cyst volume seems to decrease when it is flexed.

Experienced clinicians can confirm the diagnosis through examination. Usually B-ultrasound can provide further evidence, and B-ultrasound can even observe whether the cyst is connected with the joint cavity.

Popliteal cyst has obvious symptoms and needs treatment. There are two traditional treatment methods, puncture and aspiration and surgical treatment. In the past, the cyst was separated by posterior incision until the opening of knee joint, and then the cyst was taken out after ligation at the opening.

However, the recurrence rate of popliteal cyst puncture and open surgery is very high. Puncture and aspiration can not relieve the cause of popliteal cyst, and recurrence is not difficult to understand. The failure of open surgery may be due to anatomical variation and surgical skills, and it is often difficult to correctly judge the opening of cyst. Sometimes even the cyst wall can't be completely removed.

Therefore, a correct understanding of the etiology of popliteal cyst is particularly important for choosing treatment methods. Studies have shown that many patients with popliteal cyst are complicated with knee osteoarthritis, meniscus injury, cartilage injury, loose body and so on. The pathological changes lead to the opening of synovial sac in the medial head of gastrocnemius becoming a one-way valve, and the joint fluid can only flow to the synovial sac in one direction, so it is difficult to reverse flow, thus increasing the effusion in the synovial sac and forming cysts.

Therefore, as long as we try our best to remove the pathological changes in the knee joint cavity, remove the one-way valve and open the cyst opening, so that the liquid in the cyst can communicate with the joint cavity, the liquid will not accumulate in the synovial sac again, and the cyst will be naturally eliminated.

Obviously, arthroscopy is a good means to meet the above treatment objectives. Arthroscopy can remove intra-articular lesions, flatten and enlarge the cyst opening, produce two-way flow, and eliminate cysts.

Arthroscopic surgery has three advantages: one is minimally invasive; The second is beautiful; The third is to eliminate the etiology of popliteal cyst and reduce recurrence.