Diagnostics and surgical treatment of ruptured Baker's cysts: A prospective study

贝克囊肿破裂的诊断和手术治疗:一项前瞻性研究

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Abstract

AIMS: We assessed diagnostic and arthroscopic surgery challenges the ruptured Baker's cysts (RBC) cases may present compared to intact Baker's cyst cases (IBC). The main question to explore was: Is RBC arthroscopic surgery more complex than IBS surgery? The null hypothesis was that RBC cases might present additional, and specific challenges for a surgeon and the arthroscopic procedure may be more complicated. METHODS: The prospective cohort study analyzed 100 operated patients (43 % female; mean age 61 ± 9.5 years) (2005-2022; follow-up to August 2023) diagnosed with RBC. The comparison group consisted of 100 operated patients (48 % female; mean age 57 ± 12.5 years) with IBC. We compared diagnostic challenges, surgical approaches, functional outcomes, the rates of postsurgical complications and recurrence, durations of surgery and immobilization, and the time to recovery. RESULTS: Among statistically significant results, RBCs were more frequently detected during the differential diagnosis with thrombophlebitis (28 vs. 17, p = 0.04) and by 99m-Tc-MDP radiography (30 vs. 10, p = 0.03). They frequently involved a three-port arthroscopic approach (89 vs. 71, p = 0.04), the cyst wall preservation (p = 0.03), and had the eight-day shorter time to recovery (p = 0.05). Other above-mentioned variables were similar in both groups of patients. CONCLUSION: RBCs do not present an additional challenge for a surgeon if an arthroscopic technique is used, but the diagnostic process may be challenging. Most RBCs require a three-port arthroscopic approach and permit cyst wall preservation.

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