Review article

Suprapatellar cyst: diagnostic and therapeutic possibillities

Tomislav Crnković ; Opća županijska bolnica Požega, Odjel traumatologije i ortopedije; Medicinski fakultet Sveučilišta "Josip Juraj Strossmayer" u Osijeku
Drago Gašpar ; Opća županijska bolnica Požega, Odjel traumatologije i ortopedije; Medicinski fakultet Sveučilišta "Josip Juraj Strossmayer" u Osijeku
Goran Zukanović ; Opća županijska bolnica Požega, Odjel abdominalne kirurgije
Robert Kolundžić ; Klinički bolnički centar "Sestre milosrdnice", Zagreb, Klinika za traumatologiju

Abstract

The suprapatellar bursa is located between the quadriceps tendon and femur, and it develops before birth as a separate synovial compartment proximal to the knee joint. Even though the anatomy describes and defines the suprapatellar bursa and its communication with the knee joint cavity very well, the fact is that in practice joint cavity and suprapatellar bursa are still considered as one synovial area, and the border between them is a more or less expressed synovial fold also known as the suprapatellar plica. By the fifth month of fetal life, there is a suprapatellar septum between the knee joint cavity and suprapatellar bursa which later perforates and involutes in a way that a normal communication between the cavity of bursa and knee is established. A small portion of the embryonic septum can later lag as more or less expressed suprapatellar plica. In the case when the suprapatellar plica has a small communication with the valve mechanism or in the case of complete septum, the bursa becomes a separate compartment and potential place for suprapatellar cyst development. In literature, thereare synonyms for this kind of pathology such as suprapatellar synovial cyst, suprapatellar bursitis or antefemoral cyst. In diagnosis, some authors have used ultrasound, arthrography, scintigraphy and computed tomography. However, in literature, the MRI is recognized as the “gold standard” in diagnosis of knee cysts because of its ability to show the cystic nature of the lesion, its relationship with other anatomic structures, as well as to establish whether other knee pathologies are present. Considering treatment possibilities, the majority of cysts around the knee in children resolve spontaneously and should be treated conservatively covering aspiration and the application of corticosteroids. Surgical treatment is reserved for large cysts with unspecific synovitis, or with hemorrhage inside the cyst, with pain and limited range of motion, or with associated intra-articular pathology. Although, according to the available literature, the suprapatellar cyst as a very rare knee pathology is treated by an open excision. In conclusion, we can point out that it can also be effectively and safely treated by arthroscopic decompression without recurrence and followed by a fast and functional recovery of the patient.

Keywords

suprapatellar cyst; bursitis; diagnostic; therapy

Hrčak ID:

187158

URI

https://hrcak.srce.hr/187158

Publication date:

3.10.2017.

Article data in other languages: croatian

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