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First published on April 16, 2004, doi:10.1177/0363546503258706

(American Journal of Sports Medicine 2004;32:1022.)

A more recent version of this article appeared on June 1, 2004
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Article

Proximal Tibiofibular Joint Ganglion Cysts

Shana Miskovsky, MD, Christopher Kaeding, MD, Lawrence Weis, MD

Ohio State University Medical Center, Department of Orthopedic Surgery, Columbus, Ohio

* To whom correspondence should be addressed.


  Abstract

Objective: Proximal tibiofibular joint proximal tibiofibular joint cysts are rare entities that can cause disability. Excision remains the traditional surgical treatment. Cyst recurrence has been a problem. This study reviews one of the largest series of patients with proximal tibiofibular joint cysts and evaluates the role of a new surgical option, proximal tibiofibular joint fusion.

Methods: Thirteen patients were admitted to the institution between 1987 and 1999. Diagnoses were confirmed by magnetic resonance imaging and histological examination. A database was compiled after medical record review. Patients completed a phone survey describing activity levels, symptom severity, recurrence history, and additional surgery. Average postoperative follow-up and average time to date of survey were 1.7 and 6.3 years, respectively.

Results: Patient complaints included lateral knee "fullness" (75%) and peroneal nerve dysesthesias (54%). Twelve patients opted for surgery: cyst excision (8) and cyst excision with proximal tibiofibular joint fusion (4). A recurrence rate of 13% (1/8) following primary excision was observed. A 100% (3/3) repeat recurrence rate was noted in second resections. Four patients underwent proximal tibiofibular joint fusion: 2 with a recurrence history and 2 for primary treatment. At follow-up, all fusion patients were without cyst recurrence or activity limitations. Procedure morbidity was minimal.

Conclusions: Proximal tibiofibular joint cysts can recur after simple excision. Repeat resection after a recurrence is often not effective. Proximal tibiofibular jointarthrodesis appears to be a more effective surgical option after a recurrence.

Key Words: tibiofibular, cyst, recurrence




This article has been cited by other articles:


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 Am. J. Roentgenol.Home page
B. B. Forster, J. S. Lee, S. Kelly, M. O'Dowd, P. L. Munk, G. Andrews, and L. Marchinkow
Proximal Tibiofibular Joint: An Often-Forgotten Cause of Lateral Knee Pain
Am. J. Roentgenol., April 1, 2007; 188(4): W359 - W366.
[Abstract] [Full Text] [PDF]


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