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ABSTRACT: Cysts of the medial meniscus are rare. They may present as a local tumor or may mimic signs of an internal derangement. The pathology may be treated by arthroscopic subtotal meniscectomy alone if the meniscal tear and cyst communicate, by local cyst excision and reattachment of the meniscus, or total meniscectomy. Two cases are presented with a review of the literature.
Introduction
Cysts of the knee menisci are uncommon. They were originally described by Nicaise in 1883 '; Ebner2 gave the first detailed description when he reported "ganglion of the cartilage" of the knee joint. Subsequent reports have been published in the literature3-14 describing medial and lateral meniscal cysts, their frequency, possible etiology, and treatment. Cysts of the medial meniscus occur less frequently than those of the lateral meniscus. This ratio has been reported as 1:3," -15 1:4,7 l:5,616 and 1:10. "The authors agree that symptomatic cysts of the menisci are uncommon and that symptomatic cysts of the medial meniscus are rare. We are reporting two cases of symptomatic cysts of the medial meniscus because of the unusual presentation of Case 2 and the diverse treatments undertaken for the two cases.
Case Reports
Case 1
J. W. Q., a 33-year-old white male, sustained a direct blow to the medial side of his right knee with subsequent medial jointline pain and effusion. He was initially examined 2 weeks after injury and stated that there had been minor, recurrent, medial jointline pain for several years, but no locking, effusion, or giving-way. The acute injury produced an increase in pain and the development of effusion, prompting his evaluation.
Physical examination showed full range of motion, normal ligamentous stability, a mild effusion, and a mass on the medial jointline which was exquisitely painful to palpation. X-rays were normal.
At arthroscopy, a degenerative horizontal cleavage tear with a flap component of the posterior third of the medial meniscus was seen. An arthroscopic subtotal medial meniscectomy was performed. The peripheral rim of the medial meniscus was intact and no communication between the cleavage tear and the mass could be demonstrated. Therefore, the mass was explored through a separate incision. We expected to find a synovial cyst, but instead, a cyst of the medial meniscus was identified, attached to...