Question Dr.H my name is tm oneil and i have been an expert
in the field of auto repair for A/E for some time
,so first let me say "thankyou!!"
My wife has a bakers cyst + 4months in the back of her knee.It has been given her alot of pain"most days"
Celibrex helps a little but,she wants to have it removed !!What is involved and what are the risks
Any responce will be helpfull.Thankyou,tm.
Answer Backer's cyst is always in that location.
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.
