Baker’s Cyst with Knee Osteoarthritis: Clinical and Therapeutic Implications

Abstract

<b><i>Objective:</i></b> Several symptoms are common to knee osteoarthritis and Baker’s cyst. To what extent each condition contributes to the patient’s discomfort is still a matter of debate. The aim of the present study was twofold: first, to compare the burden of symptoms in patients with isolated knee osteoarthritis and patients with knee osteoarthritis associated with Baker’s cyst; second, to assess the outcomes after conservative treatments. <b><i>Subject and Methods:</i></b> Patients suffering from monolateral idiopathic knee osteoarthritis were enrolled. Demographic, anthropometric and clinical data (KOOS scale) were collected. Ultrasound evaluation was performed according to standard protocols. On the basis of the clinical presentation different therapeutic options were used (fluid withdrawal, hyaluronic acid and/or steroids injections). <b><i>Results:</i></b> One-hundred and thirty patients were included in the study (97 with isolated knee osteoarthritis, 33 with knee osteoarthritis and Baker’s cyst). In basal conditions, lower scores in KOOS sub-scales were observed in patients with knee osteoarthritis associated with Baker’s cyst and in patients with effusion compared with patients without effusion. At 3 months after therapy significant higher scores were observed in both groups. At 6 months the scores were unchanged in the patients without Baker’s cyst, but worsened in those with Baker’s cyst. <b><i>Conclusions:</i></b> The study shows that Baker’s cysts associated with knee osteoarthritis contribute to the burden of symptoms. The conservative treatment of both conditions allows significant improvements, but in the medium term (6 months) the efficacy of the therapy declines in patients with knee osteoarthritis associated with Baker’s cyst.

Assessment of Imaging Factors Associated with Baker’s Cyst Rupture on Knee MRI

“…In clinical conditions, such as inflammatory or degenerative arthropathy, which can cause increase of intra-articular pressure due to increase of joint effusion, the effusion may enter into the cyst. Furthermore, development of Baker’s cyst was associated with ACL tear and meniscal tear [ 15 16 17 ]. Therefore, it was thought that there may be factors contributing to the cyst rupture, just as there were many factors affecting the cyst development.…”

An Update on Clinical Utility of Musculoskeletal Ultrasonography in Knee Osteoarthritis

“…55 Baker Cyst Baker cyst (BC) results from fluid enlargement of the gastrocnemio-semimembranosus bursa located in the medial aspect of the popliteal fossa, and is more frequently found in patients suffering from KOA and increases with severity of OA and duration of disease. 56,57 On MRI imaging, BC is usually well defined and unilocular, and fluid can be identified wrapping around the medial gastrocnemius tendon and concave towards the midline. 58 BC is considered to be one of the causes of stiffness and pain in KOA, which can be easily diagnosed with MSUS even in patients without symptoms at the popliteal fossa.…”

Arthroscopic Treatment of Popliteal Cyst Through the Posterior Portal: A Comprehensive Clinical Study

“…Popliteal cysts, commonly known as Baker’s cysts, are relatively common, particularly in adults aged 35 to 70 years, with a slightly higher prevalence in females. While many patients are asymptomatic, symptomatic presentations include visible swelling, pain, stiffness, and a feeling of tightness in the posterior knee [ 1 , 2 ]. These symptoms often worsen with activities involving knee flexion or extension.…”