Baker's cyst of the knee: what is this disease and how to treat it

Reasons for the development of the disease

Factors that contribute to the formation of Baker's cyst have been studied for many years. Modern traumatologists and orthopedists identify a number of reasons that entail the development of a neoplasm:

1. Hard physical labor.
2. Intense sports activities with stress on the knee joints.
3. Inflammatory processes in the joint. The motor activity of the knee joint depends on the synovial fluid, which acts as a shock absorber. It washes all the structural elements of the joint and, as it were, lubricates them. During inflammation, synovial fluid leaks from the joint into the tendon bursa. She cannot return back, since the valve prevents this. This is how a cyst is formed. Moreover, the longer the inflammation lasts, the more fluid is produced in the knee joint and removed from it, the larger the size of the Baker cyst becomes.
4. Dystrophic changes caused by osteoarthritis, osteoarthritis, rheumatoid arthritis.
5. Injuries - rupture of knee ligaments, damage to cartilage, meniscus.
6. Excess weight, which puts excessive stress on the knee joints.

Conservative treatment

A Becker cyst is characterized by the accumulation of synovial fluid in the popliteal fossa, which is visualized by a pronounced symptom - a tubercle on the skin. Such formation is very dangerous, since pathogenic microorganisms often penetrate into the hernia cavity, intensifying the inflammatory process. Therefore, the doctor’s first priority is to remove the accumulated synovial fluid. For this, a wide needle equipped with a pumping device is used. Then glucocorticosteroids are injected into the vacated cavity:

• Diprospan. The drug exhibits pronounced antishock, desensitizing and anti-inflammatory activity. The main ingredient of the hormonal agent, betamazone phosphate, helps reduce the severity of pain and swelling of soft tissues. Despite its effectiveness, Diprospan has serious contraindications. The glucocorticosteroid is not used if there is a bacterial infection in the joint cavity, recent knee surgery, or hematopoietic disorders.
• Hydrocortisone. The active substance of the drug exhibits activity similar to the hormone synthesized by the adrenal cortex. Hydrocortisone significantly accelerates metabolism, promoting rapid tissue regeneration. After introducing a glucocorticosteroid solution into the cyst cavity, healing processes are started, microcirculation is normalized, and the inflammatory process is stopped. Hydrocortisone is also characterized by a pronounced anti-edematous and analgesic effect. The likelihood of side effects does not allow the use of a hormonal drug in the treatment of patients with stomach ulcers, erosive gastritis, acute or chronic renal failure.

When the above glucocorticosteroids are introduced into the synovial bursa, pain or other discomfort rarely occurs. But in some cases, to prevent their development, a combination of injectable hormonal and anesthetic agents (Procaine, Lidocaine) is used.

One of the effective ways to treat a Becker cyst is to perform a puncture to pump out synovial fluid.

Antibiotic therapy

If there is an outpouring of synovial fluid into the soft tissues, then in most diagnosed cases a bacterial infection develops. Antibiotics and antimicrobial agents are used to destroy pathogenic microorganisms. Before drawing up a therapeutic regimen, laboratory tests are carried out to establish the species of the infectious pathogen and its resistance (resistance) to antibacterial agents. In accordance with the test results, the patient is prescribed a course of antibiotics belonging to the following groups of drugs:

• macrolides - Azithromycin, Clarithromycin;
• cephalosporins - Ceftriaxone, Cefazolin, Cefotaxime;
• semisynthetic penicillins - Amoxiclav, Panclave, Augmentin.

If a bacterial infection in the knee joint is rapidly progressing, sulfonamides (Co-trimoxazole) and antimicrobial agents (Metronidazole) may be included in the treatment regimen.

If the acute inflammatory process is accompanied by severe pain and swelling, then non-steroidal anti-inflammatory drugs are administered intramuscularly.

Long-term use of NSAIDs, antibiotics, and glucocorticosteroids causes damage to liver cells, the death of beneficial intestinal microflora, and a decrease in the body's resistance to viral and bacterial infections. This condition can trigger a relapse of the disease. To prevent the popliteal fossa from filling with synovial fluid again, patients are prescribed a course of medications:

• balanced complexes of vitamins and microelements - Selmevit, Makrovit, Centrum;
• hepatoprotectors - Karsil, Phosphogliv Forte, Essentiale Forte, Rezalut;
• probiotics and prebiotics - Bifidumbacterin, Lactobacterin, Enterol, Normaze, Linex.

When diagnosing any pathology of the musculoskeletal system, including Becker’s cyst, doctors include chondroprotectors (Dona, Artra, Structum) in the therapeutic regimen. Their use is most relevant with the rapid progression of the disease and its frequent relapses. Long-term use of chondroprotectors serves as an excellent prevention of destructive and degenerative changes in cartilage and joints.

A course of taking chondroprotectors will help prevent painful recurrences of Becker's cyst

Baker's cyst symptoms

The initial stage of the formation of a Baker's cyst does not bring any unpleasant sensations to a person. Symptoms increase as the tumor grows larger. Pain occurs when nearby nerve fibers are compressed. Involvement of nerve endings and surrounding soft tissues in the process entails a number of unpleasant symptoms:

• tingling feeling in the lower part of the leg;
• numbness of the sole;
• restriction in movement;
• feeling of fullness under the knee;
• edema;
• pain that intensifies with physical activity, walking;
• a change in skin pigmentation, first over the area of ​​the cyst, and then throughout the entire limb.

The insidiousness of Baker's cyst is that a long asymptomatic course is followed by rapid growth and the development of complications.

Lack of medical treatment causes:

1. Atrophy of the lower leg muscles due to compression of blood vessels and nerves. The patient experiences constant pain, so he spares the leg and limits physical activity. The imaginary calmness of the limb gives less pronounced unpleasant sensations.
2. Disorder of local sensitivity, the appearance of trophic ulcers. Impact on the surrounding feeding vessels and disruption of innervation invariably provokes the development of thrombophlebitis, and in severe cases, gangrene, which is difficult to treat conservatively.
3. Compression of the knee vein leads to stagnation of venous blood, subsequently phlebitis, thrombosis and varicose veins.
4. Rupture of the cyst membrane. A serious condition, which is accompanied by severe swelling of the lower leg, intense pain, and increased body temperature.
5. Thromboembolism and ischemia are the most severe complications that can lead to death.

Upon examination and palpation of the cyst, a somewhat painful oblong neoplasm under the knee is determined, which has an elastic, dense structure. The size of the tumor can vary from small to large. In the early stages of a cyst, the skin over it does not change color.

Treatment with ointments, gels, balms and creams

In the treatment of Becker cysts, external agents are actively used to stop the inflammatory process at an early stage of the pathology. As a rule, the doctor prescribes them as part of complex therapy along with glucocorticosteroids, NSAIDs, and chondroprotectors. The first choice drugs are external anti-inflammatory drugs:

• Voltaren gel,
• Fastum gel,
• Indomethacin ointment,
• Piroxicam,
• Ketonal.

When diagnosing a cyst pressing on small and large blood vessels, patients are recommended to use external agents that improve microcirculation - Indovazin, Troxevasin, Lyoton. To eliminate pain, swelling in the joints, and stiffness of movement, frequent rubbing with creams and balms with bear fat, golden mustache, shark fat, cinquefoil, and horse chestnut is used.

How to treat Baker's cyst of the knee

Therapeutic tactics for Baker's cyst depend on the duration of development of the pathology, the size of the formation, and the clinical picture. Treatment can be either conservative or surgical. Conservative methods include physiotherapeutic procedures, the prescription of symptomatic medications, and puncture of the cyst.

The puncture consists of evacuating the liquid contents of the cyst with a syringe and further administering one of the glucocorticoid drugs (diprospan, flosterone). All manipulations are performed under general or local anesthesia and with mandatory ultrasound control.

The following medications are prescribed:

• steroid hormones in the form of injections;
• hydrocortisone;
• painkillers;
• anti-inflammatory;
• muscle relaxants.

The drugs are prescribed only by a doctor, all injections are performed in a medical facility.

Physical therapy complex

Physical therapy is prescribed to patients who have undergone surgery to remove a Baker's cyst, or as an additional method for conservative treatment.

Exercise therapy classes have several goals:

• strengthen the ligaments of the knee joint;
• stretch the gluteal, thigh, calf and quadriceps muscles;
• stretch your hamstrings.

Specially designed exercises help eliminate fatigue, reduce the tone of tense muscles, and restore blood supply to the limb.

The exercise therapy complex includes the following exercises:

• alternately bending and straightening the legs at the knees while sitting on a chair;
• a similar exercise, but with weights on the ankles;
• chair squats and stand-ups;
• pulling your legs to your chest while sitting on the floor.

For maximum therapeutic effect, it is necessary to perform exercises under the supervision of a specialist – a rehabilitation specialist.

The patient must follow certain rules:

1. Warm up your muscles before starting exercise.
2. Do not engage in sports training that places intense stress on your knees.
3. Do not overwork your leg muscles, perform all exercises measuredly. If muscles become tired, stop training.
4. All exercises are performed on a special surface.

All patients with a Baker's cyst in the popliteal fossa are recommended to take long walks (up to 20 km per day), swimming in the pool, and exercise on an exercise bike. You can learn about the exercise therapy complex by following the link.

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.

Physiotherapy

Physiotherapeutic procedures are prescribed after relief of an acute inflammatory process or during the rehabilitation period after surgery. A pronounced effect is obtained during a series of sessions:

• mechanical traction - prevents the development of atrophy;
• massage of the knee joint and lower legs - to restore blood supply and nutrition of soft tissues;
• electrophoresis - activates tissue regeneration, normalization of metabolic processes;
• UHF, infrared laser therapy - to relieve pain, eliminate inflammation and swelling;
• magnetic therapy - restores metabolic processes and restores damaged tissue at the cellular level;
• hydrogen sulfide, radon baths - for the prevention of thrombophlebitis, varicose veins, stimulation of local blood circulation.

During physiotherapy, the condition of the damaged knee joint and the degree of its motor activity are constantly assessed. You can learn more about physiotherapy methods here.

Clinic

Symptoms of changes that develop as a result of trauma appear acutely, their intensity is proportional to the degree of impairment. Among them:

• Pain that develops mainly on the inside of the knee and intensifies when trying to carry out active or passive movements in it.
• Restriction of mobility, which can reach a complete block when part of the cartilage is torn off and wedged. Any attempts at movement usually lead to a sharp increase in discomfort.
• Inflammatory manifestations in the form of redness, swelling of soft tissues. They lead to a visually noticeable increase in the knee. There is a local increase in temperature (the knee joint becomes hot to the touch).

In pathological disorders leading to degeneration of internal cartilage, symptoms develop gradually over a fairly long period of time. The pain may be absent at first, then it appears and intensifies with loads on the leg. Movements may be accompanied by characteristic “clicks” and “crunches,” which indicates the development of degenerative processes in cartilage tissue.

Surgery

Surgical removal of Baker's cyst of the knee joint is carried out according to certain indications:

• ineffectiveness of drug and physiotherapeutic treatment;
• excessively large size of the tumor;
• presence of signs of rupture of the cyst membrane;
• signs of necrotic changes in the popliteal fossa;
• impairment of motor functions in the knee joint.

Surgical removal of the tumor is performed in one of the following ways: traditionally, using an arthroscope or laser.

Traditional removal is performed under local anesthesia. The doctor makes an incision over the cyst, isolates it and resects it. After removal, the surgical wound is inspected, the blood vessels are coagulated and sutured layer-by-layer.

Arthroscopy involves minimally invasive surgical removal of a Baker's cyst. During the operation, soft tissues are practically not injured and blood vessels are not damaged. The cyst is removed using special instruments. The entire process is displayed on the monitor, as a micro-video camera is inserted into the knee joint.

The laser provides high temperature - up to 800 ° C, with which the cyst is coagulated. The liquid contents are evacuated, and a light guide is inserted into the cyst cavity. Next, it is heated and the walls of the cavity are glued together.

Home treatment methods

• 30g of the root part of elecampane is filled with water, at the rate of 3 liters of water for this amount of substance, adding 1 tbsp. l. yeast. Infusion occurs for 48 hours. The liquid is placed in a place protected from light rays. Take 0.5 cups before meals 4 times a day. The anti-inflammatory effect of treating Baker's cyst with a folk remedy will reduce the active development of the process.

There are alternative treatments for Becker cysts. These treatment programs include Sujok therapy, which involves influencing certain points located on the hands. Reflexology, manual therapy, kinesitherapy and psychocorrection can also be used. However, the use of alternative methods is permitted only after approval by the attending physician.

In some cases, the formation may disappear on its own. But more often physiotherapeutic or surgical treatment is required. Obviously, for this a person goes to the hospital. An alternative to the hospital is to treat small cysts at home. Some physiotherapeutic techniques can be used at home, but more often in such an environment traditional methods of treating Baker's cyst are recommended.

Compress to relieve inflammation

The pathological formation itself is most often not threatening, and usually goes away without treatment after 2-3 years when the load on the joints is reduced.

There are still complications. Firstly, there is pain and tension when moving, joint blocking, and the development of varicose veins due to stagnation of blood in the veins. Sometimes the membrane may rupture and fluid may leak under the skin.

Home therapy is aimed precisely at alleviating the condition, designed to prevent complications, discomfort and cure the knee completely.

X-ray for Baker's cyst

The diagnosis of the disease should be carried out by a specialist with a special medical education - this is an indisputable statement. Especially if it concerns a child.

Treatment with traditional methods for Baker's cyst of the knee joint will be more effective if it takes place in parallel with medical prescriptions and under the supervision of a medical professional.

Individual intolerance to any components in folk recipes cannot be ignored.

When preparing mixtures, it is important to use a quantitative formulation. Some components in excessive doses turn from drugs into poisons.

Methods such as external procedures and taking internal healing tinctures can be combined.

Clove decoction for compresses

Mix one tablespoon of dried elderberry and raspberry leaves and steam with 100 ml of boiling water. Leave for half an hour with the lid closed. Place the steamed leaves on a waterproof material and apply to the affected area for at least two hours.

Celandine lotions help to cure many ailments associated with the knee joints. A medicinal lotion is prepared according to the principle of the first recipe.

For this compress you need pre-crushed dandelion root and spicy cloves. A tablespoon of cloves is steamed in 100 ml of boiling water for 10 minutes, but the root should be boiled in 150 ml during this time, after which these products are combined and a spoonful of medical alcohol is added. Wrap the cloth soaked in the composition around the knee, insulate it, and keep it there for 3 hours every day.

Mix 250 gr. Bile and 160 ml of camphor alcohol. The mixture can be stored in the refrigerator in a glass container. Place a cloth soaked in the mixture behind the knee, cover with compress paper, and insulate it. Time – 4 hours every day for a month.

Medicinal ointments

Ointment for the treatment of Baker's cyst

A good way to cure growths, lumps and cysts is ointments based on medicinal herbs and other components.

Calendula and propolis. Crush a tablespoon of marigolds and pour in goose fat. Place in a water bath and stirring continuously, add propolis until completely dissolved. Do not allow it to boil, as the beneficial properties of propolis disappear with strong heat.

Regular unrefined sunflower oil treats Baker's cyst well. Warm oil compresses are applied twice a day - morning and evening.

Grind fresh marigold flowers and mix with melted badger fat in a 1:1 ratio. Lubricate the cyst site at night.

Apple cider vinegar and honey for compresses

It is more effective to treat Baker's cyst with external medications in combination with internal cleansing.

The same marigolds from the home flower bed are taken in the form of a decoction. To do this, boil a tablespoon of chopped flowers for 5 minutes in 0.5 liters of water and leave for 40 minutes. Take 150 ml before meals 2 times a day. After 20 days of use, take a break for a week. Three such courses can be conducted.

Golden mustache is infused with vodka. A three-liter jar is filled three-quarters with green mass and topped up to the brim with vodka. The mixture is ready for use after 20 days. Take 2 tablespoons twice a day. The herb from the tincture is used as a compress.

Herbal tea, which includes two parts of St. John's wort and one each of birch buds, nettle, lingonberry, mint, knotweed and plantain, is drunk three times a day, one hundred grams. Prepare as an infusion: 1 tbsp. spoon of mixture per 300 ml of water.

Apple cider vinegar in combination with honey helps reduce the amount of fluid in the cyst bursa. Use 3 times a day as follows: a tablespoon of vinegar, a teaspoon of honey in a glass of warm water.

Features of treatment of the disease in children

Baker's cyst is most often found in children under 7 years of age. As a rule, pathology does not appear on its own, but against the background of inflammatory diseases of the joints or after injuries. The symptoms of the disease are practically no different from the clinical picture that develops in adults.

If the Baker's cyst does not cause discomfort in the child and does not grow rapidly, it is monitored for some time. Surgical treatment is prescribed only for severe impairment of the motor function of the knee joint. In children, good therapeutic results can be achieved through systematic physiotherapeutic procedures and exercise therapy.

Treatment of Baker's Cyst in Naberezhnye Chelny

Only an experienced doctor can make the correct diagnosis, identify the root cause of the pathological process and prescribe adequate treatment for Baker’s cyst. At the Center for Restorative Medicine in Naberezhnye Chelny, a specialist in the field of orthopedics and traumatology can easily diagnose and treat any joint pathologies.

The cost of the clinic's services can be found by following the link. If you have any questions regarding the treatment of Baker’s cyst and other pathologies of the musculoskeletal system, you can make an appointment with a doctor by calling +7 (8552) 78-09-35, +7 (953) 482-66-62. It is important to remember that timely contact with a specialist speeds up the healing process, so don’t wait, call right now!

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.