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Knee Surgery, Sports Traumatology,... Jul 2006A popliteal cyst, originally called Baker's cyst, is a synovial fluid-filled mass located in the popliteal fossa. The most common synovial popliteal cyst is considered... (Review)
Review
A popliteal cyst, originally called Baker's cyst, is a synovial fluid-filled mass located in the popliteal fossa. The most common synovial popliteal cyst is considered to be a distension of the bursa located beneath the medial head of the gastrocnemius muscle. Usually, in an adult patient, an underlying intra-articular disorder is present. In children, the cyst can be isolated and the knee joint normal. The anatomy, etiopathogenesis, clinical presentation, differential diagnosis, imaging and treatment modalities of the popliteal cyst are presented. The authors try to answer some questions dealing with this condition. Is the cyst isolated, can it be treated as such, is its origin always well-defined and does surgical excision provide a permanent cure?
Topics: Diagnostic Imaging; Humans; Orthopedic Procedures; Popliteal Cyst; Practice Patterns, Physicians'; Surveys and Questionnaires; Terminology as Topic
PubMed: 16362357
DOI: 10.1007/s00167-005-0028-z -
Orthopedics Aug 2014Baker's cyst, or popliteal cyst, is a fluid-filled mass that is a distention of a preexisting bursa in the popliteal fossa, most commonly the... (Review)
Review
Baker's cyst, or popliteal cyst, is a fluid-filled mass that is a distention of a preexisting bursa in the popliteal fossa, most commonly the gastrocnemio-semimembranosus bursa. This bursa is unique in that it communicates with the knee joint, unlike other periarticular bursae, via an opening in the joint capsule posterior to the medial femoral condyle. Many have theorized that this opening creates a valve-like mechanism in the presence of effusion that contributes to the formation of these cysts in adults. Popliteal cysts rarely manifest alone and are most often found in conjunction with other intra-articular pathologies and inflammatory conditions, such as osteoarthritis, meniscus tears, and rheumatoid arthritis. In children, popliteal cysts are only occasionally associated with these conditions and are more often an incidental finding discovered during a routine physical examination. Popliteal cysts may present as either a chronically persistent or relapsing condition or as an acute and dramatic condition that can occur in the case of cyst rupture presenting as pseudothrombophlebitis. Ultrasound and magnetic resonance imaging have proven to be consistent and accurate in the confirmation of popliteal cysts, with magnetic resonance imaging becoming the modern imaging modality of choice. This review discusses the anatomy and etiology of popliteal cysts, describes the common clinical presentations, reviews the differential diagnoses, and provides guidance for proper diagnostic imaging. It also provides a comparison of current conservative, minimally invasive, and invasive treatment options, along with a discussion of results. Postoperative rehabilitation depends largely on the condition associated with the popliteal cyst.
Topics: Adult; Child; Humans; Popliteal Cyst
PubMed: 25102502
DOI: 10.3928/01477447-20140728-52 -
Zhongguo Gu Shang = China Journal of... Feb 2019Popliteal cyst is a common peri-knee cyst, also known as a Baker's cyst. With the current development of popliteal cysts, the pathogenesis is mainly due to increased... (Review)
Review
Popliteal cyst is a common peri-knee cyst, also known as a Baker's cyst. With the current development of popliteal cysts, the pathogenesis is mainly due to increased pressure in the knee joint caused by various reasons, leading to a fluid-filled sac that can form behind the knee as a result of enlargement of the gastrocnemius-semimembranosus bursa. The current diagnostic methods include X-ray computed, ultrasound, and magnetic resonance. Among them, magnetic resonance imaging is considered the gold standard for the diagnosis of popliteal cysts. There are various treatments, including conservative treatment, traditional surgical resection and arthroscopic surgery. In recent years, the focus of the treatment of popliteal cysts has gradually shifted from the simple removal of cysts to arthroscopic treatment of intra-articular lesions and the treatment of joint-cyst communication, and achieved a good effect. However, there are still controversies about the most effective treatment, and the best surgery method is still uncertained. It is hoped that high quality prospective studies will be able to directly compare different surgery methods, so as to select the best treatment for popliteal cyst. This article reviews past literature research and describes in detail the epidemiology, pathological mechanism, clinical manifestations and signs, auxiliary examination, diagnosis and differential diagnosis and clinical treatment of popliteal cysts. Different diagnosis methods and treatment methods are compared and summarized to provide basis for clinical diagnosis and treatment.
Topics: Arthroscopy; Bursa, Synovial; Humans; Knee Joint; Popliteal Cyst; Prospective Studies
PubMed: 30884939
DOI: 10.3969/j.issn.1003-0034.2019.02.018 -
La Revue Du Praticien Feb 2017
Topics: Popliteal Cyst
PubMed: 30604947
DOI: No ID Found -
Journal of Orthopaedic Surgery and... Feb 2016This systematic review and meta-analysis of the clinical efficacy of different surgical methods in the therapy of popliteal cysts may provide evidence about effective... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
This systematic review and meta-analysis of the clinical efficacy of different surgical methods in the therapy of popliteal cysts may provide evidence about effective surgical treatments.
METHODS
PubMed, EMBASE, and OVID were searched with the following terms: (popliteal cyst* OR baker's cyst*) AND (arthroscopic OR excision OR operative OR treat* OR surgery). Inclusion criteria included the following: studies reported the efficacy of different surgical methods in popliteal cyst patients; patients were ≥ 16 years; and studies must have involved a minimum of 10 patients. Studies were grouped according to the surgical methods, and a meta-analysis was employed to identify the success rate based on the pooled data.
RESULTS
A total of 11 studies were included: The communication between the cyst and the articular cavity was enlarged in 7 studies; this communication was closed in 3 studies; and only intra-articular lesions were managed in 1 study. After the data were pooled, the success rates were 96.7 and 84.6 % in the communication-enlargement group and communication-closure group, respectively. Studies with communication enlargement were subgrouped into the cyst wall resection group and the non-cyst wall resection group, for which the success rates were 98.2 and 94.7 %, respectively.
CONCLUSIONS
Based on the current available evidence, at present, any how arthroscopic excision of the cyst wall, arthroscopic management of intra-articular lesions, and enlarging the communication between the cyst and the articular cavity is an ideal strategy for the popliteal cyst. The current literature on the treatment of popliteal cysts is limited to retrospective case series. Future prospective studies with high-quality methodology and uniform scoring system are required to directly compare communication-enlargement surgery and communication-closure surgery and determine the optimal treatment of popliteal cysts. Cyst wall resection may improve the therapeutic efficacy, to draw definitive conclusions, and high-level clinical researches with a large number of patients and long-term follow-up should be initiated.
Topics: Arthroscopy; Humans; Knee Joint; Popliteal Cyst; Treatment Outcome
PubMed: 26879283
DOI: 10.1186/s13018-016-0356-3 -
Medical Principles and Practice :... 2021Several symptoms are common to knee osteoarthritis and Baker's cyst. To what extent each condition contributes to the patient's discomfort is still a matter of debate....
OBJECTIVE
Several symptoms are common to knee osteoarthritis and Baker's cyst. To what extent each condition contributes to the patient's discomfort is still a matter of debate. The aim of the present study was twofold: first, to compare the burden of symptoms in patients with isolated knee osteoarthritis and patients with knee osteoarthritis associated with Baker's cyst; second, to assess the outcomes after conservative treatments.
SUBJECT AND METHODS
Patients suffering from monolateral idiopathic knee osteoarthritis were enrolled. Demographic, anthropometric and clinical data (KOOS scale) were collected. Ultrasound evaluation was performed according to standard protocols. On the basis of the clinical presentation different therapeutic options were used (fluid withdrawal, hyaluronic acid and/or steroids injections).
RESULTS
One-hundred and thirty patients were included in the study (97 with isolated knee osteoarthritis, 33 with knee osteoarthritis and Baker's cyst). In basal conditions, lower scores in KOOS sub-scales were observed in patients with knee osteoarthritis associated with Baker's cyst and in patients with effusion compared with patients without effusion. At 3 months after therapy significant higher scores were observed in both groups. At 6 months the scores were unchanged in the patients without Baker's cyst, but worsened in those with Baker's cyst.
CONCLUSIONS
The study shows that Baker's cysts associated with knee osteoarthritis contribute to the burden of symptoms. The conservative treatment of both conditions allows significant improvements, but in the medium term (6 months) the efficacy of the therapy declines in patients with knee osteoarthritis associated with Baker's cyst.
Topics: Adrenal Cortex Hormones; Aged; Aged, 80 and over; Conservative Treatment; Female; Humans; Hyaluronic Acid; Knee Joint; Male; Middle Aged; Osteoarthritis, Knee; Popliteal Cyst; Quality of Life; Ultrasonography
PubMed: 34348320
DOI: 10.1159/000518792 -
The American Journal of Medicine Apr 2021
Topics: Aged; Ecchymosis; Female; Humans; Popliteal Cyst; Rupture, Spontaneous
PubMed: 33144131
DOI: 10.1016/j.amjmed.2020.09.039 -
Orthopaedics & Traumatology, Surgery &... Oct 2023In previous studies, good results have been reported after arthroscopic treatment of popliteal cysts and concomitant intra-articular pathology. However, only a few...
BACKGROUND
In previous studies, good results have been reported after arthroscopic treatment of popliteal cysts and concomitant intra-articular pathology. However, only a few studies have reported the associated factors with residual popliteal cysts. The aim of this study was to examine the clinical and radiographic outcomes and investigate the factors associated with the recurrence of popliteal cyst after arthroscopic cyst decompression and cyst wall resection.
HYPOTHESIS
The authors hypothesized that residual popliteal cyst after arthroscopic decompression and cystectomy would be associated with degenerative cartilage lesions.
PATIENTS AND METHODS
From December 2010 to December 2018, 54 patients with popliteal cysts were treated with arthroscopic decompression and cyst wall resection through an additional posteromedial cystic portal. Magnetic resonance imaging (MRI) or ultrasonography was used to observe whether the popliteal cyst had disappeared or decreased. The maximum diameter of the popliteal cyst was measured after surgery. The patients were classified into the disappeared and reduced groups according to the treatment outcome. Age, sex, symptom duration, preoperative degenerative changes based on the Kellgren-Lawrence (K-L) grade, cartilage lesions according to the International Cartilage Repair Society (ICRS) grades, synovitis, functional outcomes, and associated intra-articular lesions were compared between the two groups. The functional outcome was evaluated on the basis of the Rauschning and Lindgren knee score. The study included 22 men and 32 women, with mean age of 49.6 years (range, 5-82 years). According to the ICRS grade system, 28 (51.8%) patients had grade 0 to II, 26 (48.2%) patients had grade III to IV.
RESULTS
Follow-up radiographic evaluation revealed that the cyst had completely disappeared in 20 patients (37%) and reduced in size in 34 (63%). The mean cyst size was decreased significantly from 5.7cm (range, 1.7-15cm) to 1.7cm (range, 0-6.4cm), and the Rauschning and Lindgren knee score showed improved clinical features in all the patients. Between the disappeared and reduced groups, the presence of degenerative cartilage lesions (p=0.022, odds ratio 8.702, 95% confidence interval: 1.368-55.362) showed statistically significant differences.
DISCUSSION
Through the posteromedial cystic portal, cysts were completely removed in approximately 40% of patients, and the size was reduced in 60% of patients. Presence of degenerative cartilage lesion represents an associated risk factor for residual popliteal cyst. These findings could be helpful in ensuring explaining poor prognostic factors.
LEVEL OF EVIDENCE
IIIb; retrospective cohort study.
Topics: Male; Humans; Female; Middle Aged; Popliteal Cyst; Cystectomy; Retrospective Studies; Arthroscopy; Treatment Outcome; Risk Factors; Decompression
PubMed: 36921759
DOI: 10.1016/j.otsr.2023.103595 -
Acta Chirurgica Belgica Apr 2017A popliteal cyst, also known as Baker cyst, is a benign fluctuant swelling of the gastrocnemius-semimembranosus bursa in the popliteal fossa at the back of the knee. The...
INTRODUCTION
A popliteal cyst, also known as Baker cyst, is a benign fluctuant swelling of the gastrocnemius-semimembranosus bursa in the popliteal fossa at the back of the knee. The cyst is named after William Morrant Baker, who is considered to have first described this fluid collection with new sac formation outside of the knee-joint in 1877. We herein present a short description contained in the Galenic Corpus that appears to match to what we now call the Baker cyst.
MATERIAL AND METHODS
Α thorough survey of Kühn's Galenic Corpus was performed.
RESULTS
The 14th book of Kühn's edition contains a brief review of all the anatomical structures and pathologies. In the 17th chapter of this treatise, devoted to skin lesions, the author states that steatomas appear in the popliteal fossa. However, it is no more believed to reflect the Galenic teaching and is ascribed to Pseudo-Galen.
DISCUSSION
With regard to the descriptions survived and the anatomy knowledge in the post-Galenic era time, the brief report of the ancient text of unknown origin, appears to match what we now describe as popliteal cyst.
Topics: History, 19th Century; Humans; Popliteal Cyst
PubMed: 28290240
DOI: 10.1080/00015458.2017.1289734 -
Journal of Vascular Surgery Dec 2011The purpose of this study was to perform a comprehensive search of the literature for all studies, case reports, and series describing Baker cyst compression of the... (Review)
Review
BACKGROUND
The purpose of this study was to perform a comprehensive search of the literature for all studies, case reports, and series describing Baker cyst compression of the neurovascular bundle in the popliteal fossa and index their findings according to the structures compressed.
METHOD
Case reports and series obtained after a thorough MEDLINE search were indexed according to compressed structures. Patient demographics, main findings, method of diagnosis, cyst size, outcomes, and follow-up were recorded for each publication.
RESULTS
Signs and symptoms related to popliteal vein and tibial nerve compression were the most frequent presentation of symptomatic Baker cysts, due to the anatomic vulnerability of these structures within the popliteal fossa and their relative sensitivity to compression. Patients with tibial nerve entrapment demonstrated gastrocnemius muscle atrophy, paresthesias, and pain. Those with popliteal vein compression experienced swelling, pain, and rarely, venous thromboembolism. Isolated arterial compression, presenting with intermittent claudication, is a rare occurrence because it is a relatively stiff-walled vessel, has a higher pressure, and is located deep in the popliteal fossa. Combinations of these compression syndromes are most frequently encountered in the context of cyst rupture and resulting compartment syndrome.
CONCLUSIONS
Baker cyst is an important pathology for the differential diagnosis of popliteal neurovascular compression phenomena. It has a wide spectrum of presentation, therefore requiring accurate diagnosis for proper patient management. Because Baker cyst is by definition a chronic disorder, long-term follow-up is necessary to monitor patient recovery and prevent recurrence.
Topics: Humans; Leg; Nerve Compression Syndromes; Popliteal Cyst; Vascular Diseases
PubMed: 21958564
DOI: 10.1016/j.jvs.2011.07.079