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Double posteromedial portal arthroscopy vs. other arthroscopic techniques for Baker's cyst: a systematic review and meta-analysis

Year: 2026
Type: review
Abstract: Background: Double posteromedial portal (DPP) arthroscopy has been proposed to improve cyst management in patients with Baker's cysts compared with other arthroscopic techniques. However, comparative evidence remains limited. Methods: A systematic review and meta-analysis was conducted according to PRISMA guidelines. Comparative clinical studies assessing DPP vs. non-DPP arthroscopic techniques for Baker's cysts were identified from PubMed, Embase, Scopus, Web of Science Core Collection and the Cochrane Library. The primary outcome was cyst recurrence or residual cyst at final follow-up. Secondary outcomes included Lysholm score, operative time, and overall complications. Pooled risk ratios (RRs) or mean differences (MDs) were calculated using fixed- or random-effects models depending on heterogeneity (I²). Sensitivity analyses were performed to assess result robustness. Results: = 232) were included. DPP arthroscopy showed a lower risk of cyst recurrence/residual cyst (RR = 0.17, 95% CI 0.04-0.74; RD = -0.08, 95% CI -0.14 to -0.02). Lysholm scores at final follow-up were similar between groups (MD = -0.65, 95% CI -2.14 to 0.84). Operative time was longer with DPP (MD = 13.20 min, 95% CI 6.16-20.24; I² = 91%), but remained longer after sensitivity analysis (MD = 10.02 min, 95% CI 7.09-12.96). Overall complications were higher with DPP (RR = 3.90, 95% CI 1.26-12.05; I² = 0%). Conclusion: DPP arthroscopy may reduce cysts recurrence compared with other arthroscopic approaches, but at the cost of longer operative time and higher complication rates. Evidence is limited to small, single-country studies with sparse recurrence events; further multicentre trials are needed.
Language: English
Subfield: Rheumatology
Field: Medicine
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W7140987556
FWCI: 2.582
Cites: 32
Cited by: 1
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