Subscribe to RSS
DOI: 10.1055/s-0036-1597139
“Baker's Cyst”–Induced Above-Knee Amputation
Publication History
17 February 2016
05 September 2016
Publication Date:
31 January 2017 (online)
Abstract
We report a 65-year-old man who presented with a necrotic fifth toe, incipient phlegmon and hypesthesia of the right foot, a swollen lower leg, and a palpable popliteal mass. An occlusion of the popliteal artery secondary to a Baker's cyst was found to have caused protracted ischemia and the abovementioned symptoms. Despite several endovascular and open-surgery procedures to restore perfusion of the limb, the patient eventually had to undergo above-knee amputation.
It might be speculated whether earlier surgery would have preserved the patient's limb. Whereas the traditional procedure of open resection of the Baker's cyst has been associated with high recurrence rates, the condition can be treated effectively and safely today by means of arthroscopic surgery. We believe that arthroscopic interventions should at least be performed in the following instances: (1) in patients with recurrent symptoms of a Baker's cyst after previous treatment of the intra-articular pathology and previous aspiration of the cyst and (2) in patients with incipient sequelae that indicate relevant compression of neurovascular structures of the popliteal fossa (pseudothrombophlebitis, intermittent claudication, neuropathy).
-
References
- 1 Johnson LL, van Dyk GE, Johnson CA, Bays BM, Gully SM. The popliteal bursa (Baker's cyst): an arthroscopic perspective and the epidemiology. Arthroscopy 1997; 13 (01) 66-72
- 2 Fritschy D, Fasel J, Imbert J-C, Bianchi S, Verdonk R, Wirth CJ. The popliteal cyst. Knee Surg Sports Traumatol Arthrosc 2006; 14 (07) 623-628
- 3 Drescher MJ, Smally AJ. Thrombophlebitis and pseudothrombophlebitis in the ED. Am J Emerg Med 1997; 15 (07) 683-685
- 4 Kashani SR, Moon AH, Gaunt WD. Tibial nerve entrapment by a Baker cyst: case report. Arch Phys Med Rehabil 1985; 66 (01) 49-51
- 5 Zhang WW, Lukan JK, Dryjski ML. Nonoperative management of lower extremity claudication caused by a Baker's cyst: case report and review of the literature. Vascular 2005; 13 (04) 244-247
- 6 Clarke JM, McCann BG, Colin JF. Popliteal artery occlusion by a popliteal (Baker's) cyst. Eur J Vasc Surg 1988; 2 (01) 61-63
- 7 Krag DN, Stansel Jr HC. Popliteal cyst producing complete arterial occlusion. A case report. J Bone Joint Surg Am 1982; 64 (09) 1369-1370
- 8 Robb D. Obstruction of popliteal artery by synovial cyst. Report of a case. Br J Surg 1960; 48: 221-222
- 9 Gulati A, Botnaru I, Garcia LA. Critical limb ischemia and its treatments: a review. J Cardiovasc Surg (Torino) 2015; 56 (05) 775-785
- 10 Mousa A, Rhee JY, Trocciola SM. , et al. Percutaneous endovascular treatment for chronic limb ischemia. Ann Vasc Surg 2005; 19 (02) 186-191
- 11 Kinlay S. Management of critical limb ischemia. Circ Cardiovasc Interv 2016; 9 (02) e001946
- 12 Rauschning W, Lindgren PG. Popliteal cysts (Baker's cysts) in adults. I. Clinical and roentgenological results of operative excision. Acta Orthop Scand 1979; 50 (05) 583-591
- 13 Ahn JH, Lee SH, Yoo JC, Chang MJ, Park YS. Arthroscopic treatment of popliteal cysts: clinical and magnetic resonance imaging results. Arthroscopy 2010; 26 (10) 1340-1347