Treatment of Popliteal (Baker) Cysts With Ultrasound-Guided Aspiration, Fenestration, and Injection: Long-term Follow-up.
BACKGROUND
The purpose of this study was to determine the efficacy of ultrasound-guided aspiration, fenestration, and injection as a treatment in patients with symptomatic popliteal cysts.


OBJECTIVE
Ultrasound-guided aspiration, fenestration, and injection (UGAFI) is an effective and safe treatment option for symptomatic popliteal cysts.


METHODS
Retrospective cohort study.


METHODS
Level 3.


METHODS
Patients who received a UGAFI of popliteal cysts from 2008 to 2011 were identified. Preaspiration (PA) and follow-up Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, cyst recurrence, complications, cyst complexity, and size were obtained and compared for statistical significance. UGAFI involved aspiration of fluid through a spinal needle, fenestration of the cyst walls and septations, and injection of 1 mL (40 mg) triamcinolone (Kenalog) and 2 mL 0.5% bupivacaine (Sensorcaine) into the decompressed remnant.


RESULTS
The mean PA WOMAC score (48.55) improved significantly at final follow-up (FFU) to 17.15 (P < 0.0001) for 47 patients. Within the WOMAC subcategories, there was also a significant difference in pain (PA, 10.68; FFU, 3.94; P < 0.0001), stiffness (PA, 4.51; FFU, 1.77; P < 0.0001), and physical function (PA, 31.34; FFU, 12.17; P < 0.0001). There were 6 reaspirations for recurrence (12.7%), and 1 patient underwent unicompartmental knee arthroplasty. There were no infections or other complications.


CONCLUSIONS
Significant clinical improvement in patients with symptomatic popliteal cysts can be achieved via UGAFI as the sole treatment.


CONCLUSIONS
UGAFI is a safe and effective option as the sole treatment modality for symptomatic popliteal cysts.
UHealth Sports Performance and Wellness Institute, Miami, Florida.
Marvin K
MK
Smith
University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Bryson
B
Lesniak
UHealth Sports Performance and Wellness Institute, Miami, Florida.
Michael G
MG
Baraga
UHealth Sports Performance and Wellness Institute, Miami, Florida.
Lee
L
Kaplan
UHealth Sports Performance and Wellness Institute, Miami, Florida jjose@med.miami.edu.
Jean
J
Jose
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000779:Anesthetics, Local / Q000008:administration & dosage; D018771:Arthralgia / Q000209:etiology / Q000517:prevention & control; D002045:Bupivacaine / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000150:complications; D011151:Popliteal Cyst / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D012008:Recurrence; D012189:Retrospective Studies; D013396:Suction / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome; D014221:Triamcinolone / Q000008:administration & dosage; D014463:Ultrasonography
D000779:Anesthetics, Local; D005938:Glucocorticoids; D014221:Triamcinolone; D002045:Bupivacaine
Baker cyst; cyst aspiration; knee; musculoskeletal ultrasound; osteoarthritis; pain management; popliteal cyst; ultrasound-guided