External meniscus ganglion
The outer meniscus is much less frequently torn in knee injuries than the inner meniscus. Although a meniscal ganglion on the outer meniscus is more common than an inner meniscal ganglion, the cause on the outer meniscus is more often a degenerative wear and tear and far less often a traumatic tear as it is more often the case with an inner meniscal ganglion.
Symptoms of a meniscus ganglion
In principle, a meniscus ganglion can be treated conservatively or by surgical intervention. Conservative therapy is only promising for smaller meniscal ganglions that have existed for a short time. The therapy is limited to the alleviation of symptoms and consists of the intake of painkillers such as diclofenac or ibuprofen, as well as the application of ointments with the same ingredients.
In many cases, the ganglion then regresses by itself, especially if the knee is spared and relieved, and surgery is not necessary. Manual compression can be used as a support, in which the ganglion is to be crushed. Due to the frequent damage to blood vessels or bony structures, this procedure is only recommended to a limited extent.
Less risky is a pressure massage, in which the filling of the ganglion is to be transported back into the joint, which, however, is accompanied by a high rate of recurrence of the cyst. Another option is to puncture the ganglion with a needle and thus relieve the pressure from the fluid removed. However, even with this type of therapy, the ganglion recurs in more than half of the cases.
The injection (insertion) of cortisone via a syringe can also be promising. If the above-mentioned therapy options have failed, if there are functional limitations in the knee joint, or if there is severe pain and cosmetic impairment or recurrence, surgical removal of the meniscus ganglion is recommended. The operation is usually performed in the form of a knee joint arthroscopy (knee arthroscopy).
In this procedure, a probe with a camera is inserted into the joint through a small incision. This gives the surgeon an overview of the entire interior of the knee joint on a screen. Small tools are inserted through further small incisions.
As a result, the meniscal ganglion is now completely removed and the cause of the ganglion, i.e. a torn meniscus or wear and tear, can be repaired at the same time. Depending on the patient’s condition, the procedure can usually be performed on an outpatient basis and under general or spinal anaesthesia. Due to the low invasiveness, the intervention is low-risk and the recovery time is short.
In rare cases, however, complications such as the formation of a blood clot (thrombosis, embolism), or pus accumulation and inflammation in the knee joint (knee joint empyema) may occur. Wound healing disorders and bleeding are also conceivable, but rather rare. In rare cases, if the meniscus ganglion is very large or the situation does not allow it otherwise, open surgery may also be necessary to achieve lasting success.
