Quiste Intra-Articular de Rodilla: Diagnóstico y Tratamiento

Introduccion: El objetivo de nuestro trabajo es presentar una serie de 35 pacientes con diagnostico de quiste articular de rodilla sintomatico tratados de forma quirurgica. Se describe el algoritmo diagnostico, los resultados y el indice de recidiva. Material y metodo: Se evaluaron en forma retrospectiva 35 pacientes con diagnostico de quiste articular de rodilla los cuales fueron tratados en forma quirurgica. Excluimos aquellos pacientes con diagnostico de ligamento mucoide y quiste para-meniscal. Veinte hombres, 15 mujeres, con una edad promedio de 39 anos. En todos ellos se realizo una biopsia escision: 31 a traves de una artroscopia y 4 reseccion a cielo abierto. La clinica variaba entre hidrartrosis, bloqueo articular y dolor inespecifico. En todos los casos se realizo el mismo algoritmo diagnostico mediante resonancia magnetica (RM). Se realizo un seguimiento clinico para evaluar recidiva. Resultados: El diagnostico se confirmo a traves de anatomia patologica en todos los casos, obteniendo 16 sinovitis vellonodular pigmentada focalizada, 5 quiste mucoide, 4 quiste sinovial, 1 quiste de tejido fibroso, 6 gangliones del LCA y 1 del LCP, 2 fibrosis postoperatorios de LCA y 2 quiste de Baker. Treinta y cuatro pacientes evolucionaron en forma favorable. Un paciente con quiste de Baker complicado evoluciono con una recidiva luego de 6 meses de la cirugia. Conclusion: La RM preoperatoria es de gran importancia, ya que los quistes se pueden localizar en zonas de dificil acceso o no exploradas en forma habitual. Es importante la sospecha de este tipo de patologia ya que con un diagnostico temprano y tratamiento quirurgico se obtienen resultados satisfactorios. Nivel de Evidencia: IV. Tipo de Estudio: Serie de Casos. Retrospectivo.(AU) Introduction: The objective of this study was to investigate a series of 35 patients diagnosed with symptomatic intraarticular knee cysts and describe the diagnostic techniques and surgical treatment. Materials and Methods: This is a retrospective study involving 35 patients diagnosed with intra-articular knee cysts who underwent surgical treatment. We excluded patients diagnosed with a mucoid ligament and para-meniscal cysts. Twenty of the patients were men, 15 women with an average age of 39 years old. All patients underwent an escitional biopsy: 31 using arthroscopy and 4 with an open resection. Among the clinical variations were hydarthrosis, joint lock and complaints of unspecific pain. All of the mentioned cases were diagnosed using MRI imaging and clinical follow up care in order to evaluate suspicion of relapse. Results: The diagnosis was confirmed through anatomic pathology in all cases, with 16 focalized pigmented villonodular synovitis, 5 mucoid cycts, 4 synovial cysts, 1 fibrosis cyst, 6 ACL ganglions, 1 PCL ganglion, 2 ACL post-operative fibrosis and 2 Bakers cycts. 34 patients showed favorable outcome and one patient with a Bakers Cyst presented complication with a relapse 6 months after the inicial surgery. Conclusion: The pre-operative MRI is of great importance, cycts can be found in areas that are difficult to access or located in areas that are rarely explored. It is important to suspect these types of pathologies due to the fact that an early diagnosis and surgical treatment lead to favorable results. Level of Evidence: IV. Study Design: Retrospective. Case series.(AU)