Excision of Posterior Cruciate Ligament Cyst Using Arthroscopic Two Portal Posteromedial Technique

Posterior cruciate ligament (PCL) ganglion cysts are rare benign lesions of the knee that can cause pain and limit the range of motion. A 42-year-old female, presented with 2 years of pain in her right knee that was worse with kneeling, full extension, and strenuous activities. Physical examination revealed tenderness in the popliteal fossa and MRI confirmed the presence of a PCL ganglion cyst. A two-portal posteromedial technique is used to excise a PCL ganglion cyst that underwent arthroscopic surgery under combined spinal and epidural anesthesia. Two posteromedial portals were created, and the cyst was removed with a combination of a radiofrequency wand and shaver. The cyst wall was cleared from the PCL fibers and shiny white fibers of the posterior horn of the medial meniscus were preserved. The patient tolerated the procedure well, returned to her normal activities after 2 weeks, and was able to weight bear. This case report demonstrates the effectiveness of the two-portal posteromedial technique, which gives excellent visualization of the posterior compartment and allows for the safe and effective removal of the cyst without injury to the PCL or other structures.