How are cystic lesions of the knee treated?

Updated: Dec 29, 2018
  • Author: David M Gonzalez, MD, FACS; Chief Editor: Thomas M DeBerardino, MD  more...
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Answer

Determination of the treatment plan depends on the individual patient and the patient's diagnosis. Nonoperative treatment, including limitation of activity and aspiration of the cyst (with or without injection of corticosteroids), is usually the treatment of choice. Surgical treatment should not be the first option chosen and is not required in most instances. However, once nonoperative treatment is exhausted, the surgical treatment of choice for most cystic masses is excision.

Excision of the cyst requires a thorough knowledge of the relationships of the ligaments, tendons, and bone structures of the knee. Surgical excision of these cysts has probably been performed since anatomic dissections were first begun. The surgical approach to excision is based on the location and origin of the cyst. Adhering to the basic principles of skin incisions and proper dissection of the tissues can greatly aid in achieving a good result.

In the case of meniscal cysts, the treatment approach may differ. Nonoperative measures do not accomplish much more than the temporary relief of symptoms. Symptomatic meniscal cysts are usually treated by addressing the cause and performing an arthroscopic partial meniscectomy with cyst decompression. [4] Direct excision of a meniscal cyst is rarely required.


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