Managing Occult Popliteal Cysts in Total Knee Arthroplasty: Recognition and Valve Disruption Technique

Case seriesof the cyst's valve mechanism permits decompression of fluid accumulated under pressure within the cyst cavity.After performing all the bone cuts, attention is directed toward the posteromedial capsule (Fig. 1A).The femur is elevated using a right-angled retractor to facilitate visualization of the posterior capsule.The suspected site of the valvular communication between the knee joint and the popliteal cyst is identified using curved Kocher's forceps as a probe (Fig. 1B).Once it locates the anterior flap of valve mechanism and passes into the cyst over the capsular fold acting as anterior flap of valve mechanism, a further gush of synovial fluid is generally observed.At this point, the Kocher's forceps is opened to create a space between its two arms, and electrocautery is used to split the anterior flap of valve mechanism to open up the cyst into the joint space (Figs 1C andD).Additionally, medial fold of this recently cut tissue can be excised, thus assuring that the valve mechanism does not reform during the process 1,