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baker's cyst

Posted by
Deborah [4642.163] on May 14, 2006 at 01:39:24:

Hi, I've been reading your posts on Baker's cysts on and off for a year now, since I was diagnosed with one. I have moderate but constant pain, swelling and stiffness to my right knee.

An MRI,and ultrasound, revealed a 5 mm Baker's cyst on the inner side of my right knee. However, they revealed NO arthritis or meniscal tear. This is good news, except that it leaves me little information about how the cyst developed, or how to treat it now.

My only guess is that repeated sprains to my left ankle might have put greater burden on my right leg.

Aspiration, cortisone shots and anti-inflammatories have all helped, but the cyst returns shortly after the therapy is complete. I'm not comfortable with long-term use of anti-inflammatories.

Is surgery advisable for a cyst this size? If so, how do I treat the underlying causes to prevent recurrence, if it's not clear what the underlying causes are?



Re: baker's cyst

Posted by Raman [3095.2421] on May 14, 2006 at 04:09:22:

In Reply to: baker's cyst posted by Deborah [4642.163] on May 14, 2006 at 01:39:24:

I found something on the web that may help you.

http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Baker's_cyst?OpenDocument
And http://www.jointhealing.com/pages/knee/bakers_cyst_tx.html

Also:

If it is symptomatic in deed it is better to remove it, some just aspirate the content [but it can come back[ but the best it is to remove the full cyst.
The surgery is simple and fast and as any surgery there is risk of bleeding , infection. For now Ice and/or wrapping your knee with an elastic bandage may be helpful in reducing the swelling in your knee, reducing any pain or discomfort accompanying the cyst.Baker's cysts generally disappear within a few years. Surgery is rarely required, unless the cyst grows quite large and/or interferes with movement. A cyst may actually rupture, causing swelling in the calf.

A Baker's cyst is the result of synovial fluid, which lines and lubricates the knee joint, escaping from the joint capsule. They are more common in people suffering from degenerative joint disease, or osteoarthritis.
Baker's cyst may also be the result of an injury or inflammation of the knee joint, or may be the result of a chronic knee problem other than degenerative joint disease


surgical removal which is done through an incision across the back of the knee, although it can sometimes be removed by arthroscopic surgery direct to the cyst. the surgery done on an out patient basis. Unless there is a lot of discomfort from the cyst surgery is rarely indicated.

some more details:
Anesthesia

Surgery can be slow and take over an hour to complete. Surgery is usually done under a general anesthetic, where you are completely asleep during surgery, or spinal anesthesia, where the lower half of the body is numbed. With spinal anesthesia you may be awake during the surgery, but you won't be able to see the surgery.

Surgery

Once you have anesthesia, your surgeon will make sure the skin of knee your is free of infection by cleaning the skin with a germ killing solution. An incision will be made in the skin over the cyst. The cyst is located and then separated from the surrounding tissues. The area of the joint capsule where the cyst appears to be coming from is identified. A synthetic patch may be sewn in place to cover the hole in the joint capsule left by the removal of the cyst. Special care is taken not to damage nearby nerves and blood vessels.

Your knee will be bandaged with a well-padded dressing and a splint for support. Your surgeon will want to check your knee within 5 to 7 days. Stitches will be removed after 10 to 14 days. Most of your stitches will be absorbed into your body. You may have some discomfort after surgery. You will be given pain medicine to control the discomfort you have.

You should keep your knee propped up for several days to avoid swelling and throbbing. Keep it propped up on a stack of pillows when sleeping or sitting up. Take all medicines exactly as prescribed by your physician. Be sure to keep all follow up appointments.

Complications

You should expect complete healing without complications in about 4 weeks. The most common possible complication after surgery is infection of the incision. If infection occurs, your surgeon may prescribe antibiotics to fight infection or surgery may be needed to drain the infection. After surgery, keep 24-hour phone numbers handy. Call you surgeon's office if you feel your knee is not healing as it should. Check your incision as instructed by your doctor. If you think you have a fever take your temperature. If you have signs of infection or other complications, call your surgeon right away.

These are warning signs of infection or other complications:
pain in your knee that is not relieved by your medicine
smelly discharge coming from your incision
red, hot, swollen incision
chills or fever over 100.4 F
you notice bright red blood coming from you incision
if you have side effects from your medicine

Baker's cyst form very near the major nerve and blood vessels of the leg. It is possible that these structures can be injured during surgery. If an injury happens, it can be a serious complication. Injury to the nerves can cause numbness or weakness in the foot and lower leg. Injury to the blood vessels may require surgery to repair the blood vessels.

In addition, it is uncommon but possible that another cyst can occur.

Rehabilitation

After your surgery you can resume daily activities and work as soon as you are able. Your doctor may want you to use crutches or a cane for awhile. Avoid vigorous exercise for 6 weeks after surgery. You should be able to resume driving 2 weeks after surgery. You may need a short course of physical therapy to regain the strength in your leg.

Summary

While a popliteal cyst is not a life-threatening problem, a ruptured cyst can mimic one and can be cause for concern until a diagnosis is made. It is important to know that these cysts are always limited to the knee. The cysts are not cancerous and will not become cancer.

Removal of the entire cyst, if necessary, will usually give a very good result. The cure is often permanent, but preventing further cyst depends a great deal on the success of treating the underlying cause.

hope this answers your question
thanks

Follow Ups:


Re: baker's cyst BIG SIGH! Archive.

Posted by Walt Stoll [93.1889] on May 15, 2006 at 07:08:41:

In Reply to: baker's cyst posted by Deborah [4642.163] on May 14, 2006 at 01:39:24:

Hi, Deborah.

5mm is less than a quarter of an inch. Are you sure you have the dimensions correct? I really cannot see anyone agressively treating this level of Bakers "cyst"--unless they are only in it for the money (in my opinion).

Treatment for a Bakers is NEVER "complete" until the rent that is allowing the leak is discovered and closed.

You are putting much too much faith in the "magical" accuracy of MRIs, "modern medicine" and ultrasound to diagnose early arthritic changes in the knee. It IS there and that is what you must be treating if you do not want to live with this--it will probasbly get worse.

Start underwater aerobic exercises at least 3 times a week along with the SR and whole foods diet combination (serious wellness) at once and let us know how you are doing in 6-12 months. If you do it half heartedly, do not bother doing it at all. Maybe, when you have suffered enough?

Walt

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Re: baker's cyst

Posted by U [914.2287] on May 23, 2006 at 09:01:30:

In Reply to: baker's cyst posted by Deborah [4642.163] on May 14, 2006 at 01:39:24:

Hi Deborah, I also have a bakers cyst behind my left knee on and off and when it comes back it is very painful and hard to walk without a cane. But ever since the doctor got my edema under control, I have not been bothered with it.Do you suffer from extra water in your system? When the water in your knee ( we all have some) gets to much, it forms a little cyst. It is bothersome and painful, but not a major thing to worry about. If you are not on diuretics, put your legs up as much as you can. It will relieve some, but dietetics help more. I would not go through the surgery, since it will return when the pressure of excess water builds up.

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