• Marvin K Smith, Bryson Lesniak, Michael G Baraga, Lee Kaplan, and Jean Jose.
• UHealth Sports Performance and Wellness Institute, Miami, Florida.
• Sports Health. 2015 Sep 1; 7 (5): 409-14.

BackgroundThe purpose of this study was to determine the efficacy of ultrasound-guided aspiration, fenestration, and injection as a treatment in patients with symptomatic popliteal cysts.HypothesisUltrasound-guided aspiration, fenestration, and injection (UGAFI) is an effective and safe treatment option for symptomatic popliteal cysts.Study DesignRetrospective cohort study.Level Of EvidenceLevel 3.MethodsPatients who received a UGAFI of popliteal cysts from 2008 to 2011 were identified. Preaspiration (PA) and follow-up Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, cyst recurrence, complications, cyst complexity, and size were obtained and compared for statistical significance. UGAFI involved aspiration of fluid through a spinal needle, fenestration of the cyst walls and septations, and injection of 1 mL (40 mg) triamcinolone (Kenalog) and 2 mL 0.5% bupivacaine (Sensorcaine) into the decompressed remnant.ResultsThe mean PA WOMAC score (48.55) improved significantly at final follow-up (FFU) to 17.15 (P < 0.0001) for 47 patients. Within the WOMAC subcategories, there was also a significant difference in pain (PA, 10.68; FFU, 3.94; P < 0.0001), stiffness (PA, 4.51; FFU, 1.77; P < 0.0001), and physical function (PA, 31.34; FFU, 12.17; P < 0.0001). There were 6 reaspirations for recurrence (12.7%), and 1 patient underwent unicompartmental knee arthroplasty. There were no infections or other complications.ConclusionSignificant clinical improvement in patients with symptomatic popliteal cysts can be achieved via UGAFI as the sole treatment.Clinical RelevanceUGAFI is a safe and effective option as the sole treatment modality for symptomatic popliteal cysts.© 2015 The Author(s).

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