Baker’s Cyst of the knee

What is a Baker’s Cyst of the Knee?

A Baker’s Cysts is when the natural lubricating fluids in the knee a created in excess causing pressure that can cause issues in the knee. There are many causes of Baker’s cysts but they all really come down to inflammation from a condition, inflammatory conditions such as rheumatoid arthritis can cause Baker’s cysts, or injury, such as torn cartilage, meniscus, or connective tissues (ACL, PCL). When the synovial fluid of the knee is created in excess the pressure builds and expands into a lump in the back of the knee causing issues with pain and body mechanics. Anyone can form a baker’s cyst, but they are more common in women than men. Rate of incidence also increases as we age.

What are the symptoms of a Baker’s Cyst in the knee?

The symptoms of a baker’s cyst are from the pressure they put on body mechanics. Excess fluid from the knee is being displaced to the back of the knee. This can cause a lump to form. If the fluid escapes, from rupture of a Baker’s cyst, from the knee it can migrate down the calf causing swelling and redness in the lower leg. A Baker’s cyst can cause no pain, but it is common for there to be a dull pain that gets worse when fully bending or straightening the leg, as both positions put compression on the tissues in which the cyst is nested in. Exercise, or even the flexion of muscles, can irritate the cyst which can increase the pain as well as cause a rupture.

What is the treatment for a Baker’s Cyst in the knee?

Treatment for a Baker’s cyst is not always necessary, as many of them are asymptomatic, or mildly symptomatic. Often people have a Baker’s cyst that heals on its own without them even noticing it. For those that the cyst is bothering there are some conservative options to start with and then surgical interventions for cases that just refuse to get better.

Conservative treatment for a Baker’s Cyst of the knee

Before you see a physician, you can try the first aid method R.I.C.E.

Rest – try to avoid irritating the joint further. If you have crutches you can use them to help carry the load. If you are able try having a couch day to two with your leg elevated.
Ice- Icing the knee on and off can help to reduce inflammation
Compression – compression of the joint can be helpful to reduce pain by not allowing as much fluid to accumulate.
Elevation – Elevating the joint above the heart will help keep fluid from building up in the joint or in the back of the knee.

Along with R.I.C.E you can take over the counter NSAIDs as directed on the label. Non-steroidal anti-inflammatory drugs can do wonders on most orthopedic conditions that have inflammation as a root cause, however, if you find yourself taking them for more than a week or two you may want to consult a physician as NSAIDs are known to cause stomach bleeding with chronic overuse.

If you are unable to get relief at home then a trip to a Orthopedic surgeon may do the trick. Orthopedic specialists can offer medicines to increase the safety of NSAIDs as well as injectable corticosteroids and anesthetics to reduce both inflammation and pain. If the Baker’s cyst is very large an orthopedic specialist may consider draining the cyst to relieve pressure and accompanying pain. If a Baker’s cyst is reoccurring and not responding well to treatment to relieve pain and gain mobility back then surgical intervention may be considered.

Surgical Intervention for a Baker’s cyst of the knee

There is not just one surgical fix all for a recurrent Baker’s cyst. A physician may have to used advanced imaging such as a MRI to determine the root cause of the Baker’s cyst. Since a Baker’s cyst can be caused by any inflammatory condition or injury to the knee the root cause will need to be determined and addressed. There could be damage to cartilage, the meniscus, bones, or ligaments that could be causing the issue, as well as conditions such as gout, or rheumatoid arthritis. The surgical intervention used will be the surgery for the appropriate condition that is the causal force.