Becker cyst: what it is, symptoms and treatment, puncture and removal surgery

When a benign formation develops under the knee, a feeling of discomfort occurs. It differs for different tumor sizes. The characteristic signs of the pathology in question are:

1. Ball-like formation under the knee;
2. dysfunction of the knee joint. It is difficult for a person to squat, it is uncomfortable to walk;
3. pain that occurs after compression of the muscle fibers between which the tumor is formed;
4. slight swelling;
5. a feeling of stiffness in the affected joint.

Baker's cyst

If these signs are detected, you must contact the clinic for medical attention. help. Otherwise, the cyst may rupture.

To determine the presence of a neoplasm, the patient is referred to ultrasound, MRI, CT, puncture radiography, arthroscopy.

Quite often, the pathological Baker's cavity in the joint area heals on its own after the inflammation has been relieved. It is not possible to heal completely and instantly. The recovery of the knee will be gradual.

Inflammation

Inflammation can last for about six months. At this time, care should be taken to ensure that minimal stress is placed on the affected limb. Of course, recovery is necessary after removal of a Baker's cyst of the knee. Rehabilitation specialists do not advise doing aerobics or going to the gym. Such loads increase the chance of cyst rupture. Preference should be given to yoga. It is light gymnastics that brings invaluable benefits to joints and muscles.

About the disease

For more than 100 years, there have been discussions in orthopedics regarding the etiopathogenesis of the cystic element. Over time, based on many factors, scientists agreed on a common opinion: Becker cyst

under the knee is definitely of a synovial nature. Formation can occur not only after intra-articular damage to this part of the leg, but also against the background of complete well-being, without previous trauma.

Schematic illustration.

Reasons for development

Popliteal bursitis is characterized by various etiologies. Doctors associate the development of the pathology in question with previously suffered arthritis (usually of rheumatoid origin) and severe gonarthrosis. The causes of Becker's cyst in 1948 were even associated with brucellosis . It was also confirmed that neoplasms can form against the background of pigmented villous synovitis, chronic microdamage to the joints.

The relationship between popliteal protrusion and other pathological processes occurring inside the joint has been proven. They are degenerative-dystrophic or rheumatic in nature and lead to the development of chronic synovitis. It is recognized as a predisposing factor to the development of popliteal hernia. The condition contributes to increased intra-articular pressure.

Attention! At the stage of consultation with a doctor, you need to report all injuries to your legs, especially recent ones.

Many orthopedists and rheumatologists say that popliteal bursitis never occurs in people who do not have a history of any type of knee injury.

Classification and symptoms

The neoplasm can be single-chamber, double-chamber and multi-chamber. Doctors have found that relapse of formation occurs in cases where there are multiple chambers in a cystic neoplasm. As the size of the bulge increases, the risk of it spreading to the lower leg increases. However, the considerable volume of the tumor provokes another consequence - rupture. A photo of a Becker cyst under the knee will help you understand the size of the formation that is considered threatening.

External sign.

The disease is classified into the following subtypes:

1. Symptomatic form - the course of the pathological process is characterized by severe pain. Its localization is the knee joint.
2. Idiopathic form - when the origin of the development of the disease is unclear, and it is not possible to establish the root cause even after conducting numerous types of research.

Absolutely asymptomatic development of popliteal bursitis is observed in no more than 28% of clinical cases . It is the absence of pronounced signs as atheroma forms and then develops that explains its late detection. Detection of neoplasms no earlier than stage 2 occurred when the inflamed areas were small in size.

Symptoms of a Becker cyst under the knee:

• Prolonged pain, often periodic, occurring inside the popliteal fossa immediately after physical activity.
• Feeling of discomfort, stiffness inside the limb, difficulty straightening the knee joint.
• Large formations compress the neurovascular bundle, causing swelling of the ankle joint.
• A rounded neoplasm can be felt under the knee - it is not fused to the skin.
• Performing several flexions and extensions helps to increase the size of the protrusion.
• Minor manifestations of neuropathy of the tibial nerve, when it, being large in size, pinched it.

The difficulty in identifying the etiological factor is associated with the anatomy of the knee joint, since synovial bursae, pockets, and inversions are located in this area. According to experts, the presence of multiple physiological structures complicates the early detection of the tumor. Also, this factor does not allow us to timely trace which particular anatomical part was the root cause of the development of the hernia.

The morphometric features of atheroma, regardless of the age and gender of the patient, are individual. Within the same age group, the volume of the hernia varies.

Sports activities

Often, cystic formations in the joints heal on their own after the inflammatory process is removed. However, complete healing does not occur immediately. The knee will gradually recover, based on the characteristics of the body.

The inflammation itself can last up to six months on average, when you need to protect the joint as much as possible from heavy loads. Thus, it is not recommended to engage in gym or aerobics, due to the fact that this increases the chance of rupture of the pathology. Because of this, it is necessary to do stretching and yoga, which is light gymnastics that is good for joints and muscles.

Thus, for cystic lesions of the knee joints, it is recommended to use exercises that do not have an axial load:

• First of all, you need to wrap an elastic bandage around the affected knee. Next, take a looped expander, which needs to be attached to a support located at the same level as the knee. After this, the leg is inserted into the loop and a few steps are taken back to create tension. In this case, it is necessary to carefully straighten the leg, performing 10 repetitions, increasing the number of approaches over time;
• This exercise is done while sitting on a chair. First, special weights are put on the ankles, after which the leg is straightened. It is held in this position for about one minute, and then the knee is bent by a third and you need to hold the leg like this for another 30 seconds. After this, the knee is given a rest for several minutes, placing the leg on the floor. The number of repetitions can start from 1, increasing this number over time, as well as increasing the weight of the weighting material;
• Another exercise that is beneficial for the joint should be performed while sitting on the floor with your legs extended forward. So, the healthy one will need to be pressed towards you, bending her at the knee, while a weighting agent is attached to the patient’s ankle. After this, the affected leg is raised off the floor and held for 20 seconds. At first, you can carry out the procedure without using a weighting agent.

The essence of the next complex is to eliminate muscle tension, which is considered one of the reasons leading to the appearance of a popliteal cyst. Due to their poor elasticity, severe compression of the synovial bursa occurs. https://www.youtube.com/embed/MPiqbT-xS8Y

This is due to the fact that when moving, friction occurs, causing pain and inflammation. To eliminate this factor, you need to use special exercises to stretch the back of the thigh:

• You need to stand up straight, placing your sore leg on a chair in front. After this, lean forward a little, without bending your back, but moving your pelvis back. It is necessary to bend down to such a level as to ensure a steady stretch of the muscles of the back of the thigh, and then freeze in this position for half a minute. This exercise is carried out three times;
• Lying on the floor, an elastic belt is placed on the foot of the leg affected by the cyst. Next, it is bent at the hip joint and placed in a vertical position. After this, the knee joint itself is bent about 20 degrees and left in this position for half a minute. The exercise should be repeated 3 times a day;
• To do this exercise, you need to sit on a chair, then stretch the affected leg forward and bend it slightly at the knee. Next, bend forward while maintaining a straight back. It is necessary to achieve tension in the back of the thigh and fix the position for 30 seconds.

Diagnostics

Before you plan how to treat a Becker cyst

under the knee, you will need to exclude the presence of a tumor process. To clarify the actual clinical situation, the following methods are used:

1. Blood test (clinical, biochemical).
2. Determination of blood sugar.
3. X-ray research method.
4. Ultrasound is a safe, very informative and inexpensive diagnostic method. Considering the high effectiveness of the method, the use of ultrasound has acquired leading importance in the examination program. The method is actively used for the purpose of differential diagnosis. The characteristics of synovial cysts are compared with other possible pathologies of the popliteal region. At the end of the procedure, the patient receives a photo of the Becker cyst.
5. Computed tomography and nuclear magnetic resonance in clinical practice are not performed for popliteal hernia. They are discovered completely by chance, during the examination process. The reason for patients to consult a doctor is to clarify the cause of discomfort inside the popliteal region.

Cyst on MRI.

Diagnostic punctures and then examination of synovial fluid are carried out if there are appropriate indications. An ECG is performed during preparation for surgery.

Conservative therapy

An orthopedist is involved in eliminating the type of pathology in question; if the need arises, surgeons are involved in the implementation of the therapeutic process.

Conservative treatment of Becker cyst under the knee involves the following approaches:

• unloading the joint;
• physiotherapeutic treatment;
• puncture of the tumor, followed by evacuation of the contents and administration of medications.

For therapeutic purposes, sclerosing agents are administered, in particular, a 5% alcohol solution of iodine, hormonal, and cytostatic drugs are used.

1. Physiotherapeutic treatment . Electrophoresis and UHF are recognized as the most effective methods. It is permissible to implement these treatment options only after excluding an oncological process.
2. Puncture . Performed to evacuate the contents of the hernia. When the tumor reaches stage 2-3, the contents of its capsule have a jelly-like consistency. The compacted neoplasm is difficult to puncture and subsequent evacuation of the internal part. Also in this case there is no point in administering corticosteroids.
3. A positive result is provided by hormonal treatment . Cortisone therapy is effective in 50% of all clinical cases. The scientific idea of ​​using hormonal drugs was first developed and applied by rheumatologists. Patients with a hernia that occurred against the background of rheumatoid arthritis were subject to observation. Therapeutic tactics made it possible to evaluate that after intra-articular administration of glucocorticosteroids, the size of the tumor decreased.

Pumping out liquid.

Since then, hormones have been injected directly into the popliteal swelling. Hydrocortisone emulsion was actively used, combining it with antibiotics.

Important! If the patient has hormonal diseases - problems with the thyroid gland, diabetes mellitus, a disorder of the adrenal cortex - it is necessary to inform the doctor about the existing disorders.

of Becker cyst is not always possible

leads to complete elimination of the tumor. Statistics show that in 6 out of 10 cases, the atheroma has to be excised surgically. Such results serve as the basis for the search for new therapeutic approaches and the development of more effective conservative methods of therapy.

What not to do

From the previous paragraph it is already clear what to do is highly not recommended.

• Postpone treatment until tomorrow, in the hope that everything will go away on its own.
• Overload the joint with physical activity, exercise excessive physical activity.
• Give up on everything and gain extra pounds.

No matter what they say about losing weight, this is the surest way to unload the knee joints and allow them to perform their function normally. If your joints are already affected, then losing weight will significantly ease your condition. Think about it, almost your entire weight, every kilogram, is pressing on your knees.

Don't be lazy, don't look for excuses. Currently, there are many methods that allow you to lose weight, both with and without physical exercise.

Surgical intervention

The intervention can be open or endoscopic. Open surgery involves isolating the tumor from the surrounding tissues to the anastomosis with the knee joint, after which surgeons bandage the neck and cut off the atheroma.

Surgical intervention does not always immediately give a positive result, and the recovery period proceeds without complications or complaints.

Open removal of formation.

The main concern of patients is associated with certain pathological phenomena, including:

• some feeling of a foreign object under the knee;
• inability to straighten the leg;
• difficulties with limb function;
• pain syndrome of varying degrees of intensity;
• movement of goosebumps along the surface of the leg (paresthesia);
• the ankle joint becomes cold to the touch.

The degree of manifestation of symptoms depends on the individual characteristics of the human body and its sensitivity.

Drugs for popliteal formation

Baker's cyst

Baker's cyst in the popliteal region is a secondary type of disease that arises from pathologies that develop against the background of underlying joint damage. The most common cause of cyst formation is injuries to the knee joint of varying severity. In addition, the appearance of a tumor is associated with such factors as:

1. Constant heavy loads on the knee.
2. Overweight.
3. Joint diseases: arthritis, arthrosis, gout, rheumatism.

At risk are athletes, people engaged in heavy physical labor, carrying heavy objects, elderly people and those suffering from obesity.

For Baker's cyst, the following medication groups are used:

• Non-steroidal anti-inflammatory drugs (NSAIDs): Aspirin;
• "Diclofenac";
• "Dimexide";
• "Ketoprofen";
• "Meloxicam";
• "Indomethacin";
• "Nimesulide".

Endoscopic treatment

Currently, the combination of endoscopic intervention and therapeutic and diagnostic arthroscopy of the knee joint

. This combination of techniques allows you to achieve the following results:

• Quickly relieve pain even of high intensity.
• Completely restore mobility of the knee joint.
• Minimize length of hospital stay.
• Reduce the likelihood of developing popliteal postoperative scars.

For several years now, doctors have been comparing the results of open and endoscopic surgery. The opinion of specialists is ambiguous, since all clinical cases are individual.

Comparison of endoscopic and traditional, open surgery (10 patients participated in the observation).

Complex of Bubnovsky Exercises

in the picture “Professor Sergei Mikhailovich Bubnovsky”

Professor S. M. Bubnovsky spent a lot of time developing exercise therapy complexes, the purpose of which is to prolong the functioning of the joints and spine. Exercises for Baker's cyst of the knee joint, developed by the professor, increase the elasticity of the ligaments and restore motor ability. To perform the exercises that the professor developed, you will need a rubber expander. It is recommended to buy it to perform gymnastics at home.

The expander is attached to the support

The second piece of equipment is attached to the ankle. The patient should get on all fours. The back should be near the support, the expander must be tensioned. From this position you should reach with your lower limb to your stomach. Then the knee is bent and the tape is stretched. Then return to the starting position. Similar exercises should be performed 10 times for the left and right limbs.

Another exercise with an expander

We bend the equipment twice and throw it over the door (the level should be slightly above the waist). We connect both ends of the equipment and attach it to the ankles. We lie down on our backs. The expander remains in a tense state. Then we pull both knees to the lower abdomen. It is important to create resistance to the stretched elastic band. It is enough to perform 15–20 repetitions per day.

General recommendations for gymnastic exercises

It is important to remember: Carry out physical therapy only in compliance with specific rules. We present them below:

1. Be sure to warm up your muscle fibers before exercise therapy and do stretching. After warming up, the muscle fibers become flexible and warm. Therefore, they suffer less from stress. Stretching muscles and leisurely walking increase heart rate and breathing. These processes have a beneficial effect on overall physical health. state.
2. Avoid high-impact gymnastic exercises. Strong loads on the knee area occur when playing squash, badminton, tennis, basketball, and football. The games feature sharp starts, turns, stops, jumps with subsequent landings. If you have knee pain, jumping is strictly contraindicated.
3. It is forbidden to overwork the muscles. If muscle fibers are tired, they are unable to absorb the load. This puts additional stress on the knees. An exercise program should be started slowly. You cannot increase the load every day. To optimize the load during training, it is recommended to alternate between walking and swimming.
4. The exercises should be performed on a special surface. To keep it soft, it is recommended to purchase a mat. Running and walking on the asphalt are considered a bad idea. These surfaces are unable to absorb shock. The best options are grass and dirt roads. These surfaces absorb vibration. It is also possible to walk and run on paths. Their surface is suitable.

Exercise in water

They will help in cases where the patient finds it difficult to perform exercises. In the water, the load is removed from the knees. There is less stress on the joints.

Walk more

For knee pain, walking is considered a suitable option. For severe pain, it is recommended to walk for up to 20 minutes. per day. Daily walks help you lose weight. And this further reduces the load on the knee.

Strengthen muscle fibers

A strong muscle corset helps compensate for weak, injured tendons, joints, and ligaments. The knee is supported by the quadriceps muscles and hamstrings. To strengthen the quadriceps femoris muscle, walk backwards and lift the leg (it should be straight) from a lying position. Strengthening the quadriceps helps strengthen the hamstrings.

Do not bend your knees more than 90 degrees. It is advisable to avoid full squats and leg presses. These exercises typically require bending the knee more than the specified 90 degrees. This puts increased strain and pressure on the knees.

The use of exercise equipment with reduced load on the knees

Elliptical trainers and exercise bikes are ideal for this. They provide an excellent aerobic workout. In this case, the knee joints are not loaded. Recumbent exercise bikes are considered better. Thanks to the vertical position, the load on the knees is further reduced.

When performing therapeutic exercises, do not overdo it. Otherwise, the condition may worsen. The first exercises should be carried out under the supervision of a specialist, a physiotherapist.