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:
- Hard physical labor.
- Intense sports activities with stress on the knee joints.
- 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.
- Dystrophic changes caused by osteoarthritis, osteoarthritis, rheumatoid arthritis.
- Injuries - rupture of knee ligaments, damage to cartilage, meniscus.
- Excess weight, which puts excessive stress on the knee joints.
What factors contribute to the appearance of a cyst?
Before identifying the reasons for the formation of a popliteal hernia, it is necessary to understand what a cyst is. On the back of the knee joint there is a so-called bursa, which in normal condition does not manifest itself in any way. But when an inflammatory process occurs, joint fluid begins to form faster than it can be absorbed.
Due to the anatomical structure of the knee, when it bends, excess fluid begins to be forced into the posterior sections, where it accumulates in the capsule. The longer the excessive secretion of synovial fluid occurs, the larger the hernia becomes.
The main reasons contributing to the development of cysts, experts include:
- knee injuries of varying severity;
- excessive and systematic stress on the legs;
- professional sports;
- overweight;
- damage to the cartilage tissue of the joints;
- meniscus pathology;
- osteoarthritis, arthritis, chronic synovitis.
Despite the fact that damage to the knee joint can occur at any age, older people are most often at risk, since age-related changes in the body negatively affect the general condition of the musculoskeletal system.
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:
- 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.
- 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.
- Compression of the knee vein leads to stagnation of venous blood, subsequently phlebitis, thrombosis and varicose veins.
- Rupture of the cyst membrane. A serious condition, which is accompanied by severe swelling of the lower leg, intense pain, and increased body temperature.
- 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.
What are the consequences of the disease?
If the hernia is not treated, it leads to thinning of the popliteal bursa, where the synovial fluid is collected. As a result, the capsule may rupture, and all the fluid begins to spread throughout the calf muscle. This complication is accompanied by severe swelling of the lower leg, redness of the popliteal cavity, increased temperature and the occurrence of acute pain in the joints.
Another rather dangerous complication is when the capsule does not rupture, but rapidly increases in size and begins to put pressure on the walls of blood vessels. This leads to their inflammation and the appearance of thrombophlebitis, varicose veins and thrombosis. It is worth noting that thrombosis is a fatal disease. A blood clot that breaks off can cause a stroke or block a pulmonary artery.
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.
How do hygromas and ganglia appear?
A bulge forms on the wrist joint, which is best visible when the arm is flexed. The skin over the tumor moves quite easily, but the formation itself cannot be moved away. If the hygroma is of an impressive size, then movements in the articular part are significantly limited. Also, the “bump” puts pressure on the tendons and nerves, which will cause pain. In some cases, hygromas go away on their own and do not require treatment. Ganglia grow from tendons and are a rather dense growth, which mainly grows at the base of one of the fingers. However, they are very small and rarely larger than a grain of rice. However, when clenching a fist and other movements, they can cause severe pain. The shape of the nail plate changes. As a rule, this type of synovial cyst occurs in old age as a consequence of arthrosis.
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:
- Warm up your muscles before starting exercise.
- Do not engage in sports training that places intense stress on your knees.
- Do not overwork your leg muscles, perform all exercises measuredly. If muscles become tired, stop training.
- 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.
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.
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.
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.
Diagnosis of Becker's cyst
To determine the disease, the doctor conducts a detailed examination of the patient’s knee. It is also necessary to exclude infectious inflammation. Then an ultrasound examination is performed, which is the “gold standard” for this pathology. Sometimes MRI or pneumoscintigraphy is prescribed. In case of combined pathology of the knee joint, an operation is often prescribed - arthroscopy, which is both a diagnostic and therapeutic procedure, including for this pathology, in cases where the cyst communicates with the joint cavity.
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!