Indian Journal of Orthopaedics

LETTERS TO EDITOR
Year
: 2017  |  Volume : 51  |  Issue : 2  |  Page : 229--230

Author's reply


Amite Pankaj, Deepak Chahar, Devendra Pathrot 
 Department of Orthopedics, UCMS and GTB Hospital, New Delhi, India

Correspondence Address:
Deepak Chahar
UCMS and GTB Hospital, New Delhi
India




How to cite this article:
Pankaj A, Chahar D, Pathrot D. Author's reply.Indian J Orthop 2017;51:229-230


How to cite this URL:
Pankaj A, Chahar D, Pathrot D. Author's reply. Indian J Orthop [serial online] 2017 [cited 2019 Aug 18 ];51:229-230
Available from: http://www.ijoonline.com/text.asp?2017/51/2/229/201717


Full Text

Sir,

We are grateful to Vaishya et al.[1] for showing keen interest in our article.[2] The response to your comments is as follows:

The results were assessed by parameters as outlined by Rauschning and Lindgren.[3] As all patients did not undergo postoperative magnetic resonance imaging (MRI) due to financial constraints, MRI findings were not used to evaluate the results.

Various studies [4],[5],[6] have shown that most of the cases of popliteal cyst are associated with intraarticular pathologies. Ahn et al .[7] have elaborated that the first step in treating a symptomatic popliteal cyst is performing arthroscopic treatment of combined intraarticular lesions causing chronic synovitis. We believe that management of popliteal cyst cannot be done in isolation.

Those cases who had failure of conservative management for 3 months associated with functional compromise (Grade 2 and 3 as per Rauschning and Lindgren [3]) were offered surgical intervention. Grade 1 popliteal cysts and those cases with history of previous surgical intervention in knee were not included in the study.

As this was a retrospective case series, no comparison with the control group was done. We also believe that a prospective, randomized control trial is needed further to validate the results. We agree that a 70° arthroscope is better for visualization of such lesions.

Posteromedial portal was utilized to decompress the opening of cyst; as cysts did not have any septae or loculations, complete evacuation was possible without additional posteromedial cystic portal. However, in cases with intracystic septations, an additional posteromedial cystic portal is often required.[5]

References

1Vaishya R, Krishnan M, Vijay V, Agarwal AK. Arthroscopic management of popliteal cysts. Indian J Orthop 2017;51:229.
2Pankaj A, Chahar D, Pathrot D. Arthroscopic management of popliteal cysts. Indian J Orthop 2016;50:154-8
3Rauschning W, Lindgren PG. Popliteal cysts (Baker's cysts) in adults. I. Clinical and roentgenological results of operative excision. Acta Orthop Scand 1979;50:583-91.
4Sansone V, De Ponti A. Arthroscopic treatment of popliteal cyst and associated intraarticular knee disorders in adults. Arthroscopy 1999;15:368-72.
5Stone KR, Stoller D, De Carli A, Day R, Richnak J. The frequency of Baker's cysts associated with meniscal tears. Am J Sports Med 1996;24:670-1.
6Takahashi M, Nagano A. Arthroscopic treatment of popliteal cyst and visualization of its cavity through the posterior portal of the knee. Arthroscopy 2005;21:638.
7Ahn JH, Yoo JC, Lee SH, Lee YS. Arthroscopic cystectomy for popliteal cysts through the posteromedial cystic portal. Arthroscopy 2007;23:559.e1-4.