{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T17:06:17Z","timestamp":1789664777730,"version":"4.0.1"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:00:00Z","timestamp":1774569600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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 (I\u00b2). Sensitivity analyses were performed to assess result robustness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Four comparative studies (all from China; total\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009232) were included. DPP arthroscopy showed a lower risk of cyst recurrence\/residual cyst (RR\u2009=\u20090.17, 95% CI 0.04\u20130.74; RD\u2009=\u2009\u22120.08, 95% CI \u22120.14 to \u22120.02). Lysholm scores at final follow-up were similar between groups (MD\u2009=\u2009\u22120.65, 95% CI \u22122.14 to 0.84). Operative time was longer with DPP (MD\u2009=\u200913.20\u2005min, 95% CI 6.16\u201320.24; I\u00b2\u2009=\u200991%), but remained longer after sensitivity analysis (MD\u2009=\u200910.02\u2005min, 95% CI 7.09\u201312.96). Overall complications were higher with DPP (RR\u2009=\u20093.90, 95% CI 1.26\u201312.05; I\u00b2\u2009=\u20090%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2026.1772431","type":"journal-article","created":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T06:39:36Z","timestamp":1774593576000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Double posteromedial portal arthroscopy vs. other arthroscopic techniques for Baker's cyst: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"13","author":[{"given":"Fang","family":"Li","sequence":"first","affiliation":[{"name":"Department of Orthopedics, The First People\u2019s Hospital of Jiande","place":["Jiande, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaojun","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The First People\u2019s Hospital of Jiande","place":["Jiande, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juncheng","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The First People\u2019s Hospital of Jiande","place":["Jiande, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junhua","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The First People\u2019s Hospital of Jiande","place":["Jiande, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liming","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The First People\u2019s Hospital of Jiande","place":["Jiande, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The First People\u2019s Hospital of Jiande","place":["Jiande, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,27]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1186\/s43019-025-00269-2","article-title":"Comprehensive analysis of knee cysts: diagnosis and treatment","volume":"37","author":"Hasan","year":"2025","journal-title":"Knee Surg Relat Res"},{"key":"B2","doi-asserted-by":"publisher","first-page":"e38407","DOI":"10.1097\/MD.0000000000038407","article-title":"Association of complicated baker\u2019s cysts with knee pathologies as compared to simple baker\u2019s cysts","volume":"103","author":"Kim","year":"2024","journal-title":"Medicine"},{"key":"B3","doi-asserted-by":"publisher","first-page":"535","DOI":"10.1186\/s13018-022-03430-9","article-title":"Diagnostic accuracy of ultrasound for the assessment of baker\u2019s cysts: a meta-analysis","volume":"17","author":"Liu","year":"2022","journal-title":"J Orthop Surg Res"},{"key":"B4","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1177\/1742271X231183356","article-title":"Ultrasound for suspected baker\u2019s cyst: a test of limited clinical value?","volume":"32","author":"Charnock","year":"2024","journal-title":"Ultrasound"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1433","DOI":"10.1007\/s00264-023-05745-6","article-title":"Arthroscopic cystectomy and valve excision of popliteal cysts complemented with management of intra-articular pathologies: a low recurrence rate and good functional outcomes in a series of ninety seven cases","volume":"47","author":"Malinowski","year":"2023","journal-title":"Int Orthop"},{"key":"B6","doi-asserted-by":"publisher","first-page":"732","DOI":"10.1186\/s12891-022-05658-2","article-title":"Comparison of arthroscopic internal drainage and open excision for the treatment of popliteal cysts","volume":"23","author":"You","year":"2022","journal-title":"BMC Musculoskelet Disord"},{"key":"B7","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1530\/EOR-22-0133","article-title":"Is posterior knee arthroscopy using posterior portals necessary for orthopedic surgeons? 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