الفهرس 
AcknowledgmentOnly 14 pages are availabe for public view
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Abstract
Intra-articular ganglion cysts of the knee joint are rare and mostly incidental finding in MRI and arthroscopy (3, 4, 5). Anatomy and biomechanics of the knee joint are reviewed. The exact etiology of the ganglion cysts is unknown (12, 77). However, several theories can explain
their pathogenesis like : traumatic, degenerative, developmental and articular theories (88, 117, 120, 127). Intra-articular ganglion cysts of the
knee can be detected in various locations as : cruciate ligaments (12, 16),
menisci (62, 146), parameniscal (113, 165), infrapatellar fat pad (166, 167),
alar folds (168), intercondylar notch (169, 170), medial plica (12), anterior
meniscofemoral ligament of Humphery (172), ligamentum mucosum (75),
popliteus tendon (6, 171), articular capsule (173, 186), posterior septum of
the knee (40) and stubs of ruptured ligaments (15, 108). Most of the cysts
are solitary and more common in men with the third and fourth decades
(95, 174). However lateral meniscal cysts are more common in women
(3:1) They are cystic structures with fibrous capsule, having smooth or
lobulated surface, round or fusiform in shape (14, 95, 114). Each cyst
contains a cavity filled with fluid sometimes showing internal septations,
with different sizes ranging from 0.5cm to 12cm (91, 94, 173, 177).
Histological examination shows connective tissue capsule with fibrocytes
linning the cavities and areas of myxoid degeneration (176, 183).
Most of the intra-articular ganglion cysts are asymptomatic (10, 66,
78), while others are clinically manifested by : knee pain, restriction of
movements, giving way, swelling, locking, effusion, clicking, stiffness,
tenderness, palpable masses, instability and limping. Some ganglia
communicate with the knee joint (75, 93, 107, 114, 139, 170, 190, 191).
They can be diagnosed by a variety of radiographic techniques
including arthrography, sonography, CT and MRI (1, 24). MRI is the
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method of choice for the diagnosis as it is the most sensitive, accurate and
specific method and arthroscopy confirmed the diagnosis (193, 197). These
cysts must be differentiated from a diverse group of pathological entities
(204). Symptomatic cysts needed treatment in all cases (12). A variety of
treatment modalities have been employed such as : conservative treatment,
arthroscopic needle – guided aspiration and debridment, arthroscopic
resection and surgical excision (77, 140, 213, 216).
Some ganglion cysts cause knee damage such as : bone & cartilage
erosions, chondromalacia (12), meniscal tears (156), synovitis (169), nerve
lesion (220), capsule penetration (24), osteroarthritis (192) & bone marrow
edema (78).
No recurrence after their management in many cases (218). But in
other cases the recurrence rate ranges from 1-34% (89, 94). All the patients
are free of symptoms after postoperative recovery and follow – up of 6months to 3 years (66, 118).