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

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.

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.

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.

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.