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Arthroscopic Treatment of Popliteal Cysts with and without Cystectomy: A Systematic Review and Meta-Analysis
Ji Hoon Han, MD1,*, Ji Hoon Bae, MD, PhD2,*, Kyung Wook Nha, MD, PhD3, Young Soo Shin, MD, PhD4, Dae Hee Lee, MD, PhD5, Hyun Jae Sung, MD1, and Jae Gyoon Kim, MD, PhD1
1Department of Orthopedic Surgery, Korea University Ansan Hospital, Korea University College of Medicine, Ansan; 2Department of Orthopedic Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul; 3Department of Orthopedic Surgery, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang; 4Department of Orthopedic Surgery, Veterans Health Service Medical Center, Seoul; 5Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Correspondence to: Jae Gyoon Kim, MD, PhD
Department of Orthopedic Surgery, Korea University Ansan Hospital, Korea University College of Medicine, 123 Jeokgeum-ro, Danwon-gu, Ansan 15355, Korea
Tel: +82-31-412-5043, Fax: +82-31-487-9502
E-mail: jgkim7437@gmail.com
*Ji Hoon Han and Ji Hoon Bae contributed equally to this work as cofirst authors.
Received: November 22, 2018; Revised: December 27, 2018; Accepted: January 16, 2019; Published online: March 18, 2019.
© Korean Knee Society. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Purpose: To compare the clinical outcomes of the arthroscopic treatments for popliteal cysts with and without cystectomy.
Methods: PubMed/MEDLINE, EMBASE, KoreaMed, and Cochrane Library were searched from the earliest available date of indexing through August 2016. The methodological quality of all articles was assessed according to the Coleman methodology score (CMS). Studies were grouped according to the surgical method, and a meta-analysis was conducted to identify the unsuccessful clinical outcome and complication rates.
Results: Nine studies were included; the mean CMS was 67.33 (standard deviation, 8.75 points). Cystectomy was reported in five studies; cystectomy was not performed in four studies. The odds ratio of unsuccessful clinical outcomes evaluated by Rauschning and Lindgren score was 122.05 (p<0.001) with cystectomy and 58.12 (p<0.001) without cystectomy. The effect size of complications was 0.16 (p<0.001) with cystectomy and 0.03 (p<0.001) without cystectomy. The recurrence rate was 0% with cystectomy and 6.4% without cystectomy.
Conclusions: All the currently available studies showed satisfactory outcomes in both with and without cystectomy groups. However, arthroscopic cystectomy concurrently performed with management of intra-articular lesions was associated with a relatively low recurrence rate and a relatively high incidence of complications.
Keywords: Knee, Popliteal cyst, Arthroscopy, Cystectomy, Systematic review, Meta-analysis


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