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Author Topic: arthroscopic decompression of bakers cyst as opposed to cutting it out?  (Read 3876 times)

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Offline JennyinLondon

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hi there

 i had an arthroscope last november to remove plica after fracture of patella -was healing ok bit of pain due to pattelar tendonosis then had fall and seem to have developed a cyst- on the back of one of my medial hammstrings.  They tried to aspirate in in June and drained half of it successfully in July with steroid injections.  I have been resting of work for the last two weeks and notied less pain but now back and noticing that even when i walk a little it exasperates the pain.  My general flexion and movement are ok though at times the pain wakes me u nd i feel it stops me from doing things.  Mri scan showed cartiledge and mneniscus ok however i had a consultation with my surgeon yesterday and he wants me to have a joint consultation with him and his colleague to discuss removing it.  Was told that they can cut it out incision or do smg called arthoroscopic decompression- they stick camera from the front of the knee and another incision towards the cyst and instead of cutting it out they blow a hole into it so that the cyst decompresses into the knee joint itself thus dissolving.  Apparently its fairly new but they prefer to try do this and if not successful they can then turn me over and cut it out- though they have said that cysts often return even if you cut them out! My physio is unsure if surgery is necessary  and thinks that cysts and bursitis sometimes heal without intervention - am in two minds as to the best course of action- i shall wait and see what happens after the joint consultation but at this stage feel rather umsure as to if going through something as invasive as that is actually worth it- its a smalish cyst around 18mm and am unsrue if most of tha pain i feel is niggly and related to tendonitis.  Anyone any views?

Offline Heather M.

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Re: arthroscopic decompression of bakers cyst as opposed to cutting it out?
« Reply #1 on: August 09, 2006, 08:46:38 AM »
Okay, I'm not a doctor, this is just a random thought  based on reading your story...what is *causing* the cyst?  Usually, tendonisis, plica, and Baker's cysts like the one you are describing are the signs of a knee that is *supremely* irritated.  I mean, like you've hit it with a hammer irritated.  And to take this analogy further...if someone was hitting your knee with a hammer, sure you could treat the resulting bruising with ice and creams and massage....but until the hammer work stops, the knee is going to keep getting irritated and bruised.  Does this make sense?

The things you've described--plica, tendinitis so severe and long-lasting that it became tendonosis, cysts that recur, pain with walking--these are all symptoms of a knee that is in trouble.  It sounds like the whole joint and potentially even the lining of it is involved and inflamed.  This lining is called "synovium" or "synovial tissue," and it's kind of like the smooth tissue on the inside of your cheek.  And like your cheek, you can actually pinch/nip/compress this synovial tissue; when this happens, it becomes inflamed and swells up and produces excess fluid.  Then, because everything is swollen and the synovial tissue is red and inflamed, it actually becomes easier for normal motions to continue to nip at and pinch this synovial tissue.  Again, think of biting the inside of your cheek--once you do it, it swells up and sticks out, and more often than not you continue to bite it again and again.

So anyway, if I were you I'd be interested in discussing with the doctors what might be at the root of all these painful symptoms you are having.  With your history of patellar fracture and then tendonosis, I'd be intent on discussing post-traumatic arthritis (the seam of the broken bits can never be as smooth as healthy bone, and this can sometimes lead to early onset osteoarthritis), scar tissue, and even synovitis.  You can look up any terms you don't understand using the search feature of this web page, or just post another question.

Good luck.  You're doing the right thing by taking this step to become informed on your knee condition.

Heather
Scope #1: LR, part. menisectomy w/cyst, chondroplasty
#2-#5: Lysis of adhesions/scar tissue, AIR, patellar tendon debridement, infections, MUA, insufflation
#6: IT band release / Z-Plasty, synovectomy, LOA/AIR, chondroplasty
2006 Arthrofibrosis, patella baja
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Offline JennyinLondon

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Re: arthroscopic decompression of bakers cyst as opposed to cutting it out?
« Reply #2 on: August 10, 2006, 10:02:11 AM »
thanks Heather

seeing surgeons today so will keep you all psoted.  I think the technique they are suggesting to cure cysts is qwuite new less invasive apparently.  I agree if am having tendonitis and fluid to begin with there's smg wrong though all my tests MRI blood tests didnt show any inflammation so its a mystery- no rheumatodi arthritis either so shall see.  I really dont want surgery if i can help it as my recovery alst time round was very slow and as everyone on here knows frustrating.  If anyone else out here has problems with cysts and or they got better please drop me a line.  Thanks

Offline laury

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Re: arthroscopic decompression of bakers cyst as opposed to cutting it out?
« Reply #3 on: November 20, 2006, 01:58:42 AM »
I've just found this website and signed up.  My first impression is that Heather M. must be an angel of mercy sent from above.   What in the world is your background?  Laury.

Offline sosby

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Heather,

I am probably inquiring in the wrong physical location of this web site, so I must appologize as I am new as well to this type of communication. I live in Phoenix and see you are from AZ as well. My girlfiriend has had a partical knee replacement is suffering with arthrofibrosis. Might you have any contacts you can share with anyone local relative to diagnosis, treatment, and PT. Any help would be most appreciative. My local email is [email protected] as well.

Thank you,
Tim