ENDOSCOPIC SURGICAL TREATMENT OF RECURRENT BAKER’S CYSTS

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Abstract

Purpose of the study - to study the causes of synovitis in patients with recurrent Baker’s cyst, to evaluate the effectiveness of endoscopic treatment of popliteal cysts . Materials and methods. From 2009 till 2013 we observed 34 patients with Baker's cyst. In 18 (52.9%) patients of the main group endoscopic technique was applied, in 16 (47.1%) patients of the comparison group a cystic bag was isolated and dissected with open technique, and then cystic gate was sutured. Results. In 10 (55,6%) patients of the main group the pain disappeared in the first postoperative day (p<0,05), the average hospital stay was 3,5±0,6 days (p<0,05), and the knee function completely recovered in 16 (88.9%) patients in 2 weeks postoperatively (p<0,05). A year later in 1 (5.6%) patients of the main group the signs of knee function disorders of 1 degree on a Rauschning & Lindgren scale were revealed, and in the comparison group - in 6 (37.5%) patients - disorders of varying severity (p <0.05). In 4 (25,0%) patients of the comparison group the recurrence of Baker’s cyst developed that required arthroscopic treatment, followed by complete recovery. Conclusions: Formation of Baker’s cyst is associated with an excess formation and accumulation of a synovial fluid in the knee joint owing to chronic damage of the meniscus and synovial membrane disease (p <0,05). Endoscopic technique allows to eliminate the causes of synovitis and the valve mechanism of fluid flow in the gastrocnemius-semimembranosus bag, to stop pain at earlier date, to restore the amplitude of active movement in the knee, to reduce the hospital stay and the risk of cyst recurrence, to prevent scarring in popliteal region (p <0,05).

About the authors

A. K. Dulaev

Pavlov First Saint-Petersburg State Medical University; Dzhanelidze Saint-Petersburg research institute of emergency medicine

Author for correspondence.
Email: akdulaev@gmail.com
Russian Federation

V. V. Zayats

Pavlov First Saint-Petersburg State Medical University; Dzhanelidze Saint-Petersburg research institute of emergency medicine

Email: zaiatc.vitalii@gmail.com
Russian Federation

A. V. Dydykin

Pavlov First Saint-Petersburg State Medical University

Email: a.dydykin@gmail.com
Russian Federation

I. G. Dzhusoev

Dzhanelidze Saint-Petersburg research institute of emergency medicine

Email: irlanbec@yandex.ru
Russian Federation

References

  1. Антипова О.В., Калягин А.Н., Черных С.Ю., Стойко А.С., Образцов А.А. Особенности диагностики и лечения кист Бейкера. Современные проблемы ревматологии.2012;(4):60-63
  2. Калягин А.Н., Казанцева Н.Ю. Остеоартроз: вопросы клиники и диагностики (сообщение 1). Сибирский медицинский журнал. 2005;(1):97-101
  3. Миронов С.П., Орлецкий А.К., Николаев К.А. Современные подходы к диагностике и лечению кист подколенной области. Кремлевская медицина. Клинический вестник. 2005;(2):44-47
  4. Шушарин А.Г., Половинка М.П., Морозов В.В. Новый способ лечения синовита и кисты Бейкера у пациентов с ревматоидным артритом. Международный журнал прикладных и фундаментальных исследований. 2012;(4):61-62
  5. Bandinelli F., Fedi R., Generini S. et al. Longitudinal ultrasound and clinical follow-up of Baker's cysts injection with steroids in knee osteoarthritis. Clin. Rheumatol. 2012; 31(4):727-31.
  6. Calvisi V., Lupparelli S., Giuliani P. Arthroscopic allinside suture of symptomatic Baker's cysts: A technical option for surgical treatment in adults. Knee Surg. SportsTraumatol. Arthrosc. 2007;15:1452-1460.
  7. Childress H.M. Popliteal cysts associated with undiagnosed posterior lesions of the medial meniscus. The significance of age in diagnosis and treatment. J. Bone Joint Surg. 1970;52-A:1487-1492.
  8. Cho J.H. Clinical results of direct arthroscopic excision of popliteal cyst using a posteromedial portal. Knee Surgery&Related Research. 2012;24(4):235 - 240 9. Fujikawa K. Arthrographic study of the rheumatoid knee. Part 1. Synovial proliferation. Ann. Rheum. Dis. 1981;40:332-343.
  9. Hughston J.C., Baker C.L., Mello W. Popliteal cyst: A surgical approach. J. Orthop. 1991;14:147-150.
  10. Kanekasu K., Nagashima K., Yamauchi D., Yamakado K. A clinical study of arthroscopic cystectomy on popliteal cysts associated with rheumatoid arthritis. Ryumachi. 1997;(37):761-769.
  11. Ko S., Ahn J. Popliteal cystoscopic excisional debridement and removal of capsular fold of valvular mechanism of large recurrent popliteal cyst. Arthroscopy. 2004;20:37-44.
  12. Lindgren P.G. Gastrocnemio-semimembranosus bursa and its relation to the knee joint. III. Pressure measurements in joint and bursa. Acta Radiol. Diagn. 1978;19(2):377-388.
  13. Rauschning W. Popliteal cysts (Baker's cysts) in adults. II. Capsuloplasty with and without a pedicle graft. Acta Orthop. Scand. 1980;51:547-555.
  14. Rauschning W., Lindgren P.G. The clinical significance of the valve mechanism in communicating popliteal cysts. Arch. Orthop. Trauma Surg. 1979;(95):251-256.
  15. Rauschning W., Lindgren P.G. Popliteal cysts (Baker's cysts) in adults. I. Clinical and roentgenological results of operative excision. Acta Orthop. Scand. 1979;50:583-591.
  16. Rupp S., Seil R., Jochum P., Kohn D. Popliteal cysts in adults. Prevalence, associated intraarticular lesions, and results after arthroscopic treatment. Am. J. Sports Med. 2002;(30):112-115.
  17. Snir N., Hamula M., T. Wolfson, Sherman O. Popliteal cyst excision using open posterior approach after arthroscopic partial medial meniscectomy. Arthroscopy Techn. 2013; 2(3): 295-298.

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