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Baker’s Cyst Removal

Article
Bone, Muscle, & Joint
Surgical Procedures
Contributed byKrish Tangella MD, MBAMay 04, 2018

Background Information:

What are the other Names for the Procedure?

  • Popliteal Cyst Removal

Baker’s Cyst synonyms include: Popliteal Cyst, Popliteal Fossa Cyst, Posterior Herniation of the Knee Joint, Synovial Cyst, Gastrocnemius Semimembranosus Bursal Cyst, and Synovial Cyst of Popliteal Space

What is the Baker’s Cyst Removal surgical procedure?

  • A  Baker’s Cyst Removal procedure involves the surgical removal of the Baker’s Cyst; a benign cyst filled with synovial fluid (the fluid found between joints) that results in a bulge at the back of the knee
  • The cyst usually causes no discomfort; however if it does, it is most likely due to a knee joint disorder

What part of the Body does the Procedure involve?

The Baker’s Cyst Removal procedure involves the knee joint and the space behind the knee joint.

Why is the Baker’s Cyst Removal surgical procedure Performed?

Baker’s Cyst Removal procedure is performed if Baker’s Cyst begins to cause any discomfort or pain, and sometimes for cosmetic reasons.

What are some Alternative Choices for the Procedure?

To remove unsightly cysts that cause knee pain, Baker’s Cyst Removal surgical procedure remains a gold standard technique.

What are the Recent Advances in the Procedure?

The recent advancement in the procedure is the use of prolotherapy, which stimulates the affected tissue to repair itself. Prolotherapy is often combined with medications for best results.

What is the Cost of performing the Baker’s Cyst Removal surgical procedure?

The cost of Baker’s Cyst Removal procedure depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities.

In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the surgery/procedure and post-operative care that is necessary.

When do you need a Second Opinion, prior to the Procedure?

  • It is normal for a patient to feel uncomfortable and confused by the information regarding Baker’s Cyst Removal procedure and on what needs to be done
  • If the patient needs further reassurance or a second opinion, a physician will almost always assist and also recommend another physician, if required
  • They can also choose to approach another physician independently. Besides, if the procedure has many alternatives, the patient may take a second opinion to understand and choose the best one

What are some Helpful Resources?

http://www.nlm.nih.gov/medlineplus/ency/article/001222.htm

http://www.wellbeing.ie/health-topics/bakers-cyst/

http://www.mayoclinic.com/health/bakers-cyst/DS00448/DSECTION=preparing-for-your-appointment

Prior to Baker’s Cyst Removal surgical procedure:

How is the Baker’s Cyst Removal surgical procedure Performed?

  • An incision is made over the cyst; it is identified, isolated, and severed from the surrounding tissue
  • Sometimes a graft or synthetic patch is placed at the site where the cyst was removed to cover the surface defect caused by removing the cyst
  • The skin is then closed with sutures and bandages

Where is the Procedure Performed?

Baker’s Cyst Removal is usually performed in an out-patient (surgery) facility, a physician’s clinic/office, or a hospital. Normally, the individual can go home once the procedure is completed.

Who Performs the Procedure?

The procedure is performed either by an orthopedic surgeon or a general surgeon; assisted by an anesthesiologist.

How long will the Procedure take?

The procedure may take anywhere between 45 minutes to an hour.

What do you need to tell your Physician before the Procedure?

It is very important to provide the following information to your healthcare provider. This enables your healthcare provider in assessing the risks for the surgical procedure and helps avoid unnecessary complications.

  • Provide a complete list of medications you are currently, taking to your physician. This information is useful for a variety of reasons. For example, it can help your healthcare provider prevent complications due to a drug interaction
  • If you are allergic to any specific medication or food items
  • If you are taking blood thinners, such as aspirin, warfarin, herbal supplements, or any other such medications
  • If you or your family members, have a history of bleeding disorders, or if there is a tendency to bleed more than normal
  • If you have diabetes, high blood pressure, chest pains, or have previously suffered from a heart attack
  • If you have ever been diagnosed with blood clots in your leg (deep vein thrombosis) or lung (embolism of lung)
  • If you have a history of frequent bone fractures (this may affect bone-healing, if bones are involved as part of your procedure)
  • A list of all previous surgical procedures you have undergone, like for example: Removal of appendix, gallbladder, or any other part, of your body; surgical repair of any body part, such as hernia repair, perforation of bowel wall, etc.

What Preparations are needed, prior to the Procedure?

  • The physician may evaluate the individual’s medical history to gain information related to the overall health status including the medications that are being currently taken
  • Some medications increase a person’s chances of bleeding and it may be recommended to discontinue them for a period of time, before the procedure is performed
  • Blood tests may be performed to determine if there is a bleeding tendency or any other medical conditions that prevents the person from undergoing the procedure
  • It is advised to quit smoking and the use of any nicotine based products, for a period of time before the surgery
  • The patient must avoid eating or drinking at least 8 hours prior to the surgical procedure, depending on when the procedure is arranged
  • For persons suffering from diabetes, it is important that the blood sugar stays within the normal range; if not their diabetologist may have to control blood sugar by recommending insulin and/or a combination of oral medicines
  • The physician will request your consent for Baker’s Cyst Removal procedure using an informed Consent Form.

What is the Consent Process before the Procedure?

The physician will request your consent for Baker’s Cyst Removal procedure using an informed Consent Form.

Consent for the Procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent.

You must sign the forms only after you are totally satisfied by the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure.

What Tests are needed, before the Baker’s Cyst Removal surgical procedure?

Before a Baker’s Cyst Removal surgery is performed, the patient may need to have (any or all of) the following tests done, as suggested by the physician:

  • Blood tests
  • Urine analysis
  • X-ray of both the knees
  • Ultrasound of the knee
  • Any other test as advised, depending on the health and the medical history of the patient

What are some Questions for your Physician?

Some of the basic questions that you might ask your physician are as follows:

  • What is a Baker’s Cyst Removal?
  • What does the removal procedure involve?
  • How will this procedure help?
  • Will the procedure in any way impair my mobility?
  • How soon should I get it done? Is it an emergency?
  • Who are the medical personnel involved in this procedure?
  • Where is the procedure performed?
  • What are the risks while performing the procedure?
  • Are there any complications after the procedure, or during recovery?
  • How long will it take to recover? When can I resume normal work?
  • Are there any lifestyle restrictions or modifications required, after the procedure is performed?
  • Are there any follow-up tests, periodic visits to the healthcare facility required, after the procedure?
  • How many such procedures have you (the physician) performed?
  • What are the costs involved?

During the Baker’s Cyst Removal surgical procedure:

What kind of Anesthesia is given, during the Procedure?

During the procedure the patient is either administered local anesthesia, spinal anesthesia, or general anesthesia. When general anesthesia is necessitated, the procedure is usually performed in a hospital surgery facility.

How much Blood will you lose, during the Procedure?

The amount of blood loss is generally minimal during the procedure. If complications arise during the procedure, it could lead to a further loss of blood.

What are the possible Risks and Complications during Baker’s Cyst Removal surgical procedure?

The possible complications that may arise during the surgery are:

  • Infection
  • Accidental injury to the neighboring tissue, blood vessel, nerve, or bone
  • Excessive bleeding
  • Anesthetic complications

What Post-Operative Care is needed at the Healthcare Facility after Baker’s Cyst Removal surgical procedure?

At the healthcare facility, generally there is no requirement for any post-procedure care, unless any complications arise.

After the Baker’s Cyst Removal surgical procedure:

What are the possible Risks and Complications after Baker’s Cyst Removal surgical procedure?

The possible risks and complications that may arise after Baker’s Cyst Removal surgery are:

  • Excessive bleeding
  • Slow healing
  • Recurrence of the cyst
  • Infection
  • Pain

What is the Prognosis after the Surgery?

The prognosis post-surgery is usually good.

When do you need to call your Physician?

Do contact your physician if you notice any of the following symptoms:

  • Pain around the surgical wound
  • Swelling and redness
  • Bleeding or fluid drainage
  • Fever
  • Dizziness

What Post-Operative Care is needed at Home after Baker’s Cyst Removal surgical procedures?

At home, the following post-operative care is recommended, after Baker’s Cyst Removal procedure:

  • Wash the surgical wound with a mild soap while bathing and keep it dry thereafter
  • Resume non-strenuous daily activities, as early as possible (per physician’s advice)
  • Use ice packs to reduce swelling and bleeding (or follow physician’s instructions)
  • Avoid taking non-prescribed medications
  • Avoid strenuous exercises

How long does it normally take to fully recover, from the Procedure?

Normally, it takes about 4 weeks to recover from a Baker’s Cyst Removal procedure.

Additional Information:

What happens to tissue (if any), taken out during the Procedure?

The tissue is taken for further examination and later disposed, as per the standard medical procedure.

When should you expect results from the pathologist regarding tissue taken out, during the Procedure?

  • The tissue removed is processed in the laboratory under a pathologist's supervision
  • Slide(s) are prepared once the tissue is processed and this is examined by a pathologist and a pathology report issued
  • Depending on the complexity of the case, issue of the report may take anywhere between 72 hours to a week's time

Who will you receive a Bill from, after the Baker’s Cyst Removal surgical procedure?

It is important to note that the number of bills that the patient may receive depends on the arrangement the healthcare facility has with the physician and other healthcare providers.

Sometimes, the patient may get a single bill that includes the healthcare facility and the consultant physician charges. Sometimes, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:

  • The outpatient facility or hospital
  • The orthopedic surgeon or general surgeon
  • An anesthesiologist (if anesthesia was administered)
  • A pathologist (if the tissue was sent for analysis)

The patient is advised to inquire and confirm the type of billing, before the Baker’s Cyst Removal procedure is performed.

Thanks and Gratitude:

We sincerely acknowledge and thank Dr. Douglas J. Jones for reviewing the article. His valuable input and feedback has helped enrich the contents of this article.

Douglas J. Jones, MD FACS
Board Certified General Surgeon and Faculty Member
University of Illinois, College of Medicine at Urbana-Champaign
506 S. Mathews Ave., Urbana, IL 61801, USA

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Krish Tangella MD, MBA

Pathology, Medical Editorial Board, DoveMed Team

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