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A 50-year old female patient with unilateral knee pain demonstrated a recurrent ultrasound-proven popliteal cyst (Baker's cyst). Even though a proper differential diagnosiswas done, the MRT of the knee showed in a secondary step a tibial fissure as the cause of the treatment-refractory knee pain and Baker's cyst.A fracture of the tibia is a rare cause for a symptomatic Baker's cysts. Mechanical, degenerative or inflamed diseases of the joint are more frequent associated with a Baker's cyst. [ABSTRACT FROM AUTHOR]

Copyright of Der Unfallchirurg is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Der Chirurg is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Goal of surgery: Removal of inflamed synovial tissue from the posterior part of the knee with the aim of reestablishing a normal knee function. Indications: Unsuccessful conservative treatment. Popliteal cyst accompanied by synovitis. Synovial chondromatosis. Contraindications: Acute, bacterial joint infection. Burnt-out synovitis causing minimal symptoms. Preoperative work up: Radiographs of knee. In the presence of rheumatoid processes: continuation of drug therapy. If on corticotherapy: perioperative increase of dosage. Positioning and anaesthesia: Prone. Tourniquet. General anaesthesia. Surgical technique: The operation usually precedes the anterior synovectomy. Complete removal of synovial tissue from the posteromedial and posterolateral parts through 2 approaches. Simultaneous removal of a popliteal cyst, torn menisci and/or joint mice. Debridement of the recessus and the articula surfaces can be performed as well. In the presence of flexion contracture relaxation of capsule or fascia and/or lengthening of tendons can be carried out. Postoperative management: Alternate positioning of knee between flexion and extension. Early active exercises. Quadriceps strengthening exercises. Full weight bearing after 1 to 2 weeks. Possible complications: Injury to nerves and/or vessels. Division of popliteus tendon. Flexion contracture. Recurrence. Results: An assessment is only possible when an anterior synovectomy or other procedures have also been carried out. In 149 patients we performed 212 posterior synovectomies. At the moment of follow-up, 4 and 10 years postoperatively, 14 patients had passed away and 18 had either undergone a total knee replacement or an arthrodesis. Of the remaining 117 patients 98 could be assessed (116 knees). An isolated anterior synovectomy was done in 52 knees and the superiority of the 64 combined, anterior and posterior, synovectomies was discernible. The activity state of the disease was assessed using the Laurin score: The incidence of recurrence was clearly lower when the combined approach was used-in spite of higher activity in this group. [ABSTRACT FROM AUTHOR]

Goal of Surgery: Surgical treatment of a symptomatic Baker's cyst without its removal. Indications: Symptomatic Baker's cyst resistant to conservative care and causing swelling or limitation of motion. Contraindications: Baker's cyst in patients with rheumatoid arthritis. In these cases the Baker's cyst must be removed completely. Baker's cyst caused by intraarticular lesions. Positioning and Anaesthesia: Supine. Tourniquet. Free draping. General or regional anaesthesia. Surgical Technique: The opening of the cyst will be localized through arthroscopy. Closure of the communication of the cyst with the joint through posteromedial approach after freshening of the cyst edges. Pedicled tendinous graft from the medial gastrocnemius can also be used to cover the opening. Postoperative Management: Elevation of the leg on a frame. After 4 days partial and 14 days full weight bearing. After 6 weeks return to full activities. Possible Complications: Division of the infrapatellar branch of the saphenous nerve. Injury to the saphenous nerve. Needle breakage during closure of the cyst. Recurrence. Lack of extension after closure of the cyst. Omission to freshen the edges. Results: 9 men and 6 women having a mean age 34 years were operated. The simple closure was done 12 times and a plastic covering 3 times. 2 subcutaneous haematomas and 1 superficial infection were seen. Follow-up examination after a mean of 26 months. 3 recurrences were noted, 2 in patients with rheumatoid arthritis and 1 in patients with lupus. 3 patients had disturbances of sensibility in the territory of the infrapatellar branch of the saphenous nerve. No patient had a lack of extension. [ABSTRACT FROM AUTHOR]