Baker's Cyst After TTT?

Mal-tracking, lateral release, medial reefing, tibial tuberosity transfer, patellar arthritis, patellectomy, plica, patello-femoral braces. For patellar fractures, see Board on 'Bone Breaks around the knee'.
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JEG2128
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Baker's Cyst After TTT?

Post by JEG2128 »

Hello All,
Well, I am 6 weeks post TTT. I started PT last week. I have been in an immobilizer since the surgery. I have been walking w/o crutches for 2 weeks. Through the PT, I have regained a lot of strength. But, my ROM is not improving. So, today my PT and I tried to figure out exactly why. I can only bend my knee to about 65 degrees. Past that, I get an excruciating pain in the back of my knee. My PT thinks that I have a Baker's Cyst that is preventing me from bending my leg more. At this point I am sooo frustrated. I have all this strength, but cannot bend my knee!! Has anyone else had this problem?

Thanks,
Jane :-\
Dislocations in both knees since 1993.
10/03 Lateral Release R Knee (failed)
2/14/06 TTT Fulkerson L Knee
blonndi
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Re: Baker's Cyst After TTT?

Post by blonndi »

Apparently I have this problem now too. Im 5 months post op from Meniscus repair (3rd time) and the recent MRI shows a large bakers cyst measure 4.7c. My OS saw other things as well to indicate I will need surgery again. The cyst is fluid filled and can be caused from so many reasons. Mine actually hurts and has made it so that I can not fully extend my knee. Most of the time the cysts will resolve on their own, but my experience tells me that nothing about my knee ends up being Normal. Hang in there and be pro active in your care. If it hurts they can drain it. Good luck.
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Re: Baker's Cyst After TTT?

Post by Heather_M. »

Jane,

Flexion problems after an invasive procedure like yours are more often due to scar tissue or adhesions in the joint, a condition called arthrofibrosis. Here's a brief introductory article on the topic: http://www.casebook.kneeguru.co.uk/inde ... _the_knee/

It's a pretty rare condition, and unfortunately many, many PT's and OS's out there haven't ever come across a really severe case. The symptoms for arthrofibrosis are quite varied from case to case, and in many instances they mimic other conditions like meniscal tear or tendinitis or plica syndrome. So scarring is very frequently misdiagnosed and mis-treated.

It's important to intervene quickly and find out what in fact is going on, and if you do have arthrofibrosis. If not, what else might be causing your flexion contracture. I seriously doubt a Baker's cyst, but I suppose anything is possible. I'm not a doctor, just going by common sense and the most likely reasons for 65 degrees of flexion with severe pain after a very invasive procedure....

Head on down to the soft tissue healing problems section and read about arthrofibrosis. And get in to see your OS as soon as you can to discuss why your leg isn't bending. Don't be surprised if he/she doesn't really know, or if they recommend MUA or manipulation under anesthesia. It's not a procedure I'm fond of, as it did nothing for me and has caused extensive problems for others, but again, you'll read about it in the soft tissue healing problems section. Do your homework and go to your doctor prepared with a knowledge of this potentially devastating condition and a good idea of treatment options--it can only help you on the way to getting back to normal to be informed about this. Unfortunately--and I'm not exaggerating here--if you do some extensive research using this board and the internet, you will probably know more about arthrofibrosis than most doctors!! Now I'm hopeful that since your doctor does TTT's and Fulkersons that he/she is a knee specialist and has come across this condition before and knows how to diagnose it. So that way, you'll get a good idea if you even have it or not.

Other reasons for flexion contracture or problems can include extensive swelling, contracted muscles and soft tissue, and inadequate pain control leading to guarding. Since there are so many possibilities, it's best to have your OS assess your knee to see what's going on. Your PT is a very valuable player in your knee rehab, but is not trained or generally informed enough about surgical complications to provide a trustworthy diagnosis...that's what your OS will do, with a thorough exam, x-rays, and MRI if necessary.

Good luck and keep us posted.

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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JEG2128
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Re: Baker's Cyst After TTT?

Post by JEG2128 »

Well, I just got home from the doctor. Finally got rid of the immobilizer!! Yea!! He said that the pain in the back of the knee was normal, but shouldn't be as bad as it is. So, he said to just keep working on it, with heat and bending as often as possible. Good luck to ya'll!
Dislocations in both knees since 1993.
10/03 Lateral Release R Knee (failed)
2/14/06 TTT Fulkerson L Knee
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