The use of autologous platelet-rich fibrin matrix combined with meniscal repair in the treatment of parameniscal cyst: clinical results and cyst recurrence after 2-year of follow up

Purpose Parameniscal cysts are associate with horizontal meniscal tears. Arthroscopic meniscal repair and the excision of the cyst by mini-open approach represent a valid treatment. However, the recurrence of cyst is still a current issue. Therefore, biological factors may be considered to promote the biological repair and avoid recurrence. The aim of the present study was to report the clinical results and the rate of recurrence of the cyst after minimum 2-year of follow up in a cohort of patients treated by meniscal repair and autologous platelet-rich fibrin matrix augment. Methods Patients with lateral parameniscal cyst undergoing arthroscopic meniscal repair and autologous platelet-rich fibrin matrix augment between 2016 and 2019 were retrospectively reviewed in March 2021. Inclusion criteria were absence of prior surgery on the affected knee with minimum 2-year of follow-up. Exclusion criteria were concomitant ligament lesions, rheumatic diseases and knee osteoarthritis. After reviewing the database, each selected patient was contacted and asked to participate in the study; at the follow-up evaluation all patient signed an informed consent. Tegner-Lysholm knee score, IKDC and NRS were collected before surgery and at follow-up. Results This study included 15 patients (8 male) with mean age of 32.8 years old. No recurrence of the cysts was observed. The Tegner-Lysholm knee score and IKDC subjective scores increased respectively from 41.3 ± 5.4 and 37.6 ± 5.1 at baseline to 92.3 ± 4.6 and 89.4 ± 2.6 at the final follow up. Concerning pain relief, the Numeric Pain Rating Scale (NRS) displayed a significant improvement reaching at the follow up a score of 1,3 ± 1.1 in comparison to 6.8 ± 0.9 at the baseline. Conclusion Surgical management of symptomatic lateral parameniscal cyst with cyst excision, autologous PRP membrane application and meniscus repair demonstrated excellent subjective clinical outcome with any cyst reoccurrence. Level of evidence III, retrospective cohort study.

Meniscal Repair and Parameniscal Cyst Excision with Knee Arthroscopic Surgery: A Case Report

Background: Meniscal cysts were rare case. There’s a 50 to 100% chance forming cyst to the tear if there was an injury happens. Trauma would cause tears happen in meniscus, leads to formation of hemorrhage which formed mucoid degeneration. The necrosis happens locally plus degeneration of mucoid forming a cyst. Thus, the meniscal cysts challenge the clinician to have clinical reasoning so then the patient can get accurate diagnosis and preferred management. Method: This paper is a case report of surgery on a patient present with cysts on lateral para meniscus which done arthroscopically with all inside technique. Results: The procedure which done by arthroscope and motorized shaver had a great outcome in this patient which were analyze from Visual Analog Scale (VAS) and Western Ontario and McMaster Index (WOMAC) 3 months after the procedure, and reach VAS score of 2/10 which was mild pain and 59,8 in WOMAC score. Conclusion: The arthroscopy and all inside technique with motorized shaver is a choice of lateral para meniscal cysts surgery with good results to be considered by orthopedic surgeons. Key words: Lateral, Meniscus Tear, Parameniscal cyst, Arthroscopy.

Vacuum Phenomenon in Parameniscal Cyst Masquerading as Infection – An Unusually Rare Presentation of a Common Entity

Parameniscal cysts are a common entity in daily practice and are found in association with a meniscal tear. Vacuum phenomenon within joints and discs can be seen secondary to degeneration or application of traction, which is believed to be released from adjacent soft tissues. Although the vacuum phenomenon is frequently present within the joints, it is rare within a parameniscal cyst which resulted in a diagnostic dilemma. In this article, we present an unusual case with a combination of two rare entities, vacuum phenomenon within a large parameniscal cyst, which has not been reported so far along with management considerations.