BAKERS CYSTS - A FOLLOW-UP-STUDY AFTER OPERATIVE TREATMENT

Baker's cysts have to be regarded as a secondary phenomenon of knee-jo int diseases. In the treatment of Baker's cysts, therefore, arthroscop y should be done before extirpation. In our study we wanted to look at the results of this therapeutic concept. In the surgical clinic withi n the Ruhr University of Bochum 34 patients with Baker's cysts underwe nt an operation between 1985 and 1992. In 22 patients the main symptom was swelling in the hollow of the knee, while the others reported eff usions of the knee joint, pain or restricted joint movement. In 27 cas es the diagnosis was made by ultrasound alone; in the others arthrogra phy or NMR tomography was necessary. Arthroscopy was performed in all patients, revealing lesions of the meniscus in 12 cases, rupture of th e cruciate ligament in 1, degenerative changes in 15 and chronic polya rthritis in 1. In 5 patients we could not find any pathologic changes. We observed 1 severe postoperative complication in the form of a join t infection. Histological examination of the cysts showed chronic syno vialitis in 21 patients and tuberculous arthritis in 1. In 25 of our p atients clinical and ultrasound examination were then performed an ave rage of 34 months after their operations. In 4 patients we found recur rence of cysts: 2 of these patients were found to be suffering from ch ronic knee-joint disease with effusions; 1 had recurrent hydrarthrosis together with chronic renal insufficiency; and the fourth patient had constant knee pain, though the arthroscopy did not show any pathologi c changes. In the last case our diagnosis was therefore called in ques tion. Conclusions: In most cases Baker's cysts are the result of chron ic knee-joint disease and they therefore require arthroscopic examinat ion. When recurrent knee-joint effusions arc present Baker's cysts sho uld always be suspected and looked for. Ultrasound examination can be recommended as a simple and effective method of investigation. If succ essful treatment of the knee joint is not possible a high rate of cyst recurrence must be expected.