Puncture of the Baker cyst
Patients with a Baker’s cyst have the options of conservative or surgical treatment. Initially, depending on the underlying disease and the extent of the symptoms, healing is usually achieved by means of non-surgical therapy. When puncturing a Baker’s cyst, the fluid that has accumulated inside the cyst is sucked out with a syringe.
As a result, the cyst loses size and the symptoms caused by the pressure in the knee joint usually improve. However, there is a considerable disadvantage of this treatment: it is purely symptomatic. Which might also interest you: Knee punctureWhen you puncture a Baker’s cyst, the contents of the cyst are emptied, but since the cause of the cyst is not removed, it can reoccur.
The so-called pedicle, the connecting piece between the joint capsule and the cyst, is still present. As a result, recurrences, i.e. the refilling of the cyst, occur frequently. The inflammation is also still present and can cause problems.
However, there are several ways to compensate for these factors. Firstly, it is possible to treat the cyst in parallel with drugs that reduce the inflammation. What is becoming increasingly common is also a procedure in which the remaining cyst sac is rinsed out directly with cortisone following the puncture of the cyst.
Although this may cause some side effects, it generally shows a rather high success rate. Furthermore, one simply has to make sure that the underlying disease, such as rheumatism, is treated in parallel. If this is under control, the risk of developing a Baker’s cyst again is massively reduced. If the puncture of a Baker’s cyst does not relieve the patient’s symptoms or if it repeatedly forms again, surgery should be considered.
Pain during the puncture
The pain during the puncture of a Baker’s cyst is often compared to the pain during a blood collection – ideally, one only notices the short puncture. It should be noted, however, that pain is perceived differently from person to person. Since the puncture of a Baker’s cyst is normally only performed when the affected person has pain, the relief of the pain is usually the main focus. Unfortunately, pain after the puncture can still occur. Recommendation from our editorial staff: Pain after a puncture
Risks of puncture of a Baker cyst
The puncture of a Baker cyst is a symptomatic rather than curative therapy, which means that it does not eliminate the cause of the development of a Baker cyst. With the help of a cannula, the fluid contained in the Baker cyst is removed, but the cyst itself remains. As a result, even after successful puncture of the Baker cyst, the cause of the increased formation of fluid, usually an inflammation in the area of the knee joint, remains.
In order to prevent the fluid from running back immediately after the Baker cyst has been punctured, the knee should then be bandaged for a few days. Nevertheless, there is a considerable risk that sooner or later there will be a build-up of fluid in the cyst. A further risk is that the syringe opens an access path into the joint, allowing bacteria to enter that are not normally found there.
This can lead to an infection (septic arthritis). However, the risk can be reduced as much as possible by strictly following hygiene measures. In addition, surrounding tissue such as vessels, nerves, tendons and cartilage can be injured.
However, with the use of modern ultrasound equipment, the cyst can usually be found without difficulty, so that injury to other structures has become rare. Even if the administration of cortisone in the course of a puncture of a Baker’s cyst is controversial, the remaining cyst sac is increasingly often rinsed out with cortisone. Cortisone is an anti-inflammatory drug and also only relieves the symptoms and does not cure the cause.
Since cortisone is injected directly into the desired site of action during a puncture of the Baker’s cyst, the risk of the usual side effects of cortisone is rather low. Problems can mainly be caused by the accidental injection of cortisone into tendon or fatty tissue. This can cause the tissue to regress.
If cortisone injections are used frequently, the risk of side effects is increased. Therefore, each of these injections should be used with care and generally performed no more than three times a year.
