Operative therapy of the Baker cyst
If no significant improvement of the symptoms of the Baker’s cyst can be achieved within 6 months under conservative therapy, surgical removal of the Baker’s cyst should be considered. The main focus is on the rehabilitation of the knee disease underlying the cyst, i.e. meniscus damage or arthrosis. If the knee damage can be repaired, e.g. by arthroscopy, the Baker’s cyst will regress on its own in 2/3 of the cases.
An operation of the Baker cyst itself is therefore usually not necessary. Rheumatics are an exception. Since the cyst contains inflammatory capsule tissue, this should be removed initially.
During surgery the cyst is removed in its entirety. In the case of Baker cysts connected to the joint capsule, care must be taken to prevent the stem, which is the connection between the cyst and the knee joint. In order to exclude a malignancy of the cyst, the capsule tissue removed should be examined in fine tissue.
Duration
The duration of Baker cyst surgery depends on the size of the cyst and any risks that may arise during the operation.
Pain
The pain caused by a Baker cyst is usually motion-dependent. In this case, pain occurs mainly when bending the knee joint. Pressure pain can also be detected when examining the hollow of the knee.
The pain is followed by swelling of the popliteal fossa, which can restrict movement. If a rupture of the Baker cyst occurs, stabbing and shooting pains occur in the area of the knee. In a ruptured Baker cyst, the pain is usually similar to that of an inflammation and can cause redness and overheating of the leg.
If the Baker cyst is greatly enlarged, nerves and vessels in the area of the hollow of the knee can become trapped, which can also lead to pain in the lower leg and knee area. A feeling of numbness and circulatory problems can also cause discomfort. An increased risk of thrombosis can lead to a feeling of tension and heaviness in the affected leg.
Especially a massive growth of the cyst can cause considerable complications. The space-consuming process can result in nerves and vessels being pinched off. This leads to numbness of the lower leg and foot.
There is also an increased risk of thrombosis. When removing the Baker cyst, care must be taken that the surrounding tissue is not damaged. Only if the Baker cyst is removed completely can the risk of recurrence be excluded.
In addition to damage to the surrounding tissue (nerves and vessels), the removal of the Baker cyst can also lead to wound healing disorders. Further risks can be infections, deep vein thrombosis, bruising or scarring. However, the risks of a Baker cyst operation are generally very low and depend particularly on the individual risk of the person to be operated on.