scholarly journals The fate of Baker’s cyst after total knee arthroplasty

2017 ◽  
Vol 5 (4_suppl4) ◽  
pp. 2325967117S0013
Author(s):  
Hagen Hommel

Aims and Objectives: Baker’s cysts are common in knees with degenerative changes. Common opinion is that most them vanish after treatment of the intraarticular knee disorder. The present study aimed to evaluate the fate of Baker’s cyst and its associated symptoms after TKA. Materials and Methods: In this prospective study, 105 patients with a MRI verified Baker’s cyst, primary OA and an appointment for TKA were included. Three patients were lost to follow-up (two died and one septic TKA removal). Mean age was 70.1 ± 7 years. Ultrasound was performed to evaluate the existing and the gross size of the cyst was performed before and one year (mean 12.3 ± 1.1 months) after TKA. Additionally, Baker’s cyst associated symptoms were recorded Results: After one year, Baker’s cysts were still detected in 85.3% of the patients (n = 87). There was a significant reduction in Baker’s cyst associated symptoms from before (70.6%) to after surgery (31.4%; p < 0.0001). No patients developed new Baker’s cyst associated symptoms. However, out of the 72 patients that reported preoperatively about Baker’s cyst associated symptoms, one year after surgery 44.4% (n = 32) of the patients still complained about Baker’s cyst associated symptoms. The size of Baker’s cysts decreased significantly from pre- (mean 1447 mm2) to postoperative (969 mm2) ultrasound assessment (p < 0.0001). Conclusion: Baker’s cysts vanished only in a small amount of patients (15%) one year after TKA. Nevertheless in this in general considered successful surgery, in close to half of the patients (44.4%) with preoperative Baker’s cyst associated symptoms, these symptoms did not vanish until one year after TKA. Thus, it might be worthwhile to evaluate its treatment options and include them in future treatment plans.

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Trisha Plastini ◽  
Arthur Staddon

Sertoli-Leydig Cell Tumors (SLCTs) make up <1% of all ovarian tumors and are benign or malignant, androgen-secreting tumors. Rhabdomyosarcoma (RMS) is a heterogeneous group of malignant tumors that resemble developing skeletal muscle. There have been case reports of patients with concurrent SLCT and RMS with limited treatment options. We aim to demonstrate treatment strategies used in our patients, which seemed to have prolonged survival when compared to prior case reports of patients not cured by surgical resection. Herein we describe 22 cases of SLCT with RMS elements as discussed in prior case reports and three cases from the authors’ institution. Of the 19 cases from prior case reports, five were lost to follow-up and two had NED after surgical intervention. Eleven patients had recurrence and were deceased within one year. Of those patients not surgically cured, only three patients were documented as living beyond two years, all of whom received chemotherapy. The three patients presented from our institution had clinical evidence of response to chemotherapy that is traditionally used for RMS. In conclusion, chemotherapy with doxorubicin and ifosfamide has activity in patients with SLCT and RMS as does salvage chemotherapy with vincristine, irinotecan, and temozolomide.


2020 ◽  
Vol 8 (5_suppl4) ◽  
pp. 2325967120S0028
Author(s):  
Hagen Hommel ◽  
Sebastian Kopf

Aims and Objectives: Baker’s cysts are known to be a source of discomfort and pain due to pressure on adjacent structures. They are not uncommon in patients eligible for total knee arthroplasty (TKA). Since there is a paucity of medium-term studies that assess the natural course of Baker’s cyst following TKA, in this study we report the one- and five-year outcomes of patients to elucidate the state of their Baker’s cyst following TKA. Materials and Methods: In this prospective case series, 102 TKA patients were included. All patients who received surgery had a diagnosis of primary osteoarthritis and had preoperatively presented with a Baker’s cyst. Sonography was performed to evaluate the existence and the gross size of the cyst before TKA, and sonography was repeated at one and five years after TKA. Symptoms potentially attributable to the Baker’s cyst were recorded at each assessment. In addition, the five-year assessment included a sonographic assessment of the anterior aspect of the knee to identify joint effusion. Results: Ninety-one patients were available for the five-year assessment (with an 89% follow-up rate). After one and five years, Baker’s cyst was still present in 87 (85%) and 30 (33%) patients, respectively. Of those patients who retained a Baker’s cyst at one-year follow up, 31 patients (36%) had sustained popliteal symptoms. Of those patients who continued to have a Baker’s cyst at five years, 17 patients (56.7%) were still symptomatic. The probability of entering remission was dependent on the size of the Baker’s cyst at baseline (odds ratio, 1.41; p = 0.025). The mean preoperative cyst size was 14.5 cm2. At one and five years postoperatively, the mean cyst size was 10.6 cm2 and 9.9 cm2, respectively. At five years, no association between cyst size and popliteal symptoms was found. Conclusion: Five years after TKA, the majority of the Baker’s cysts that were present at baseline had gone into remission. The probability of going into remission was dependent on the size of the Baker’s cyst at baseline.


2020 ◽  
Vol 102-B (1) ◽  
pp. 132-136
Author(s):  
Hagen Hommel ◽  
Roland Becker ◽  
Peter Fennema ◽  
Sebastian Kopf

Aims We report the natural course of Baker’s cysts following total knee arthroplasty (TKA) at short- and mid-term follow-up. Methods In this prospective case series, 105 TKA patients were included. All patients who received surgery had a diagnosis of primary osteoarthritis and had preoperatively presented with a Baker’s cyst. Sonography and MRI were performed to evaluate the existence and the gross size of the cyst before TKA, and sonography was repeated at a mean follow-up time of 1.0 years (0.8 to 1.3; short-term) and 4.9 years (4.0 to 5.6; mid-term) after TKA. Symptoms potentially attributable to the Baker’s cyst were recorded at each assessment. Results At the one-year follow-up analysis, 102 patients were available. Of those, 91 patients were available for the 4.9-year assessment (with an 86.7% follow-up rate (91/105)). At the short- and mid-term follow-up, a Baker’s cyst was still present in 87 (85.3%) and 30 (33.0%) patients, respectively. Of those patients who retained a Baker’s cyst at the short-term follow-up, 31 patients (35.6%) had popliteal symptoms. Of those patients who continued to have a Baker’s cyst at the mid-term follow-up, 17 patients (56.7%) were still symptomatic. The mean preoperative cyst size was 14.5 cm2 (13.1 to 15.8). At the short- and mid-term follow-up, the mean cyst size was 9.7 cm2 (8.3 to 11.0) and 10.4 cm2 (9.8 to 11.4), respectively. A significant association was found between the size of the cyst at peroperatively and the probability of resolution, with lesions smaller than the median having an 83.7% (36/43) probability of resolution, and larger lesions having a 52.1% (25/48) probability of resolution (p < 0.001). At the mid-term follow-up, no association between cyst size and popliteal symptoms was found. Conclusion At a mean follow-up of 4.9 years (4.0 to 5.6) after TKA, the majority (67.0%, 61/91) of the Baker’s cysts that were present preoperatively had disappeared. The probability of cyst resolution was dependent on the size of the Baker’s cyst at baseline, with an 83.7% (36/43) probability of resolution for smaller cysts and 52.1% (25/48) probability for larger cysts. Cite this article: Bone Joint J. 2020;102-B(1):132–136


2016 ◽  
Vol 98-B (9) ◽  
pp. 1185-1188 ◽  
Author(s):  
H. Hommel ◽  
C. Perka ◽  
S. Kopf

2021 ◽  
Vol 11 (5) ◽  
Author(s):  
Mandeep S. Dhillon ◽  
Pulak Vatsya ◽  
Sarvdeep S. Dhatt ◽  
Vishal Kumar ◽  
Prasoon Kumar

Introduction: Implant wear and loosening with eluding metal/polythene debris are commonly implicated in the occurrence of Baker’s cysts in post-operative total knee replacement (TKR) patients, who present with post-operative pain and swelling, mimicking deep venous thrombosis. However, we present two symptomatic cases presenting with ruptured Baker’s cysts post-TKRs, with no evidence of implant loosening or wear. Cases Report: The 1st patient was a 55-year-old male, who underwent TKR for Grade 4 bilateral knee osteoarthritis and presented with acute onset of pain and swelling over the left popliteal fossa, which progressed to involve the calf. Radiographs showed no sign of infection or loosening, and venous color Doppler and magnetic resonance imaging (MRI) showed a hy-poechoic collection in the intermuscular plane at the upper part of popliteal fossa. Histological examination of the aspirated fluid showed mixed features of cystic fluid and a resolving hematoma. There was complete resolution of the 4 months with rest and graduated physiotherapy. The 2nd patient was a 51-year-old female who developed the cystic swelling 2 years after the surgery, and the ultrasound showed hypoechoic echoes in a Baker’s cyst-like collection. Cytological findings were suggestive of hemorrhagic nature of the aspirate, without any evi-dence of polyethylene debris, and the cultures were sterile. She became asymptomatic over 4 weeks with conservative management; the swelling resolved after 3 months. Conclusion: Majority of the cases in literature show implant loosening as cause of popliteal cysts after TKRs, however present cases highlight alternative mechanisms, and there are good chances of self-resolution of cysts with conservative treatment in such cases. Keywords: Knee replacement, Baker’s cyst, deep vein thrombosis, ruptured popliteal cyst.


2021 ◽  
Vol 13 (2) ◽  
pp. 259-284
Author(s):  
Feras Jirjees ◽  
Ali K Saad ◽  
Zahraa Al Hano ◽  
Taher Hatahet ◽  
Hala Al Obaidi ◽  
...  

SARS-CoV-2 (COVID-19) has been changing the world since December 2019. A comprehensive search into many COVID-19 treatment guidelines was conducted and reported in this article. This is a review paper to probe differences in COVID-19 managing strategies and explore the most common treatment plans among countries. Published guidelines from 23 countries and three references guidelines—until the end of 2020—were included in this article. The majority of COVID-19 treatment options were reported in this review and it includes antiviral drugs, antimalarial drugs, antibiotics, corticosteroids, immunotherapy, anticoagulants, and other pharmacological treatment. The presence of such information from different countries in a single comprehensive review article could help in understanding and speculation of variation in the recommended treatment in each country. This might be related to the cost of medications, the access to the medications, availability of medication that could potentially be useful in managing COVID-19 cases, and the availability/capacity of healthcare facilities. Finally, although there are various treatment groups listed in the published therapeutic guidelines worldwide, unfortunately, there is no evidence for effectiveness of most of these medications in reducing the COVID-19 mortality curve over more than one year of this global pandemic.


2020 ◽  
pp. 20-25
Author(s):  
Denise Sackett ◽  
Tala Dajani ◽  
David Shoup ◽  
Uzoma Ikonne

The benefits of breastfeeding are well established. The World Health Organization and the Centers for Disease Control and Prevention recommend that mothers breastfeed infants for at least one year, but most children are not breastfed that long because of many factors. Breastfeeding mothers face many challenges to continued breastfeeding, including medical conditions that arise during this period, such as postpartum depression and lactational mastitis. Because of a perceived lack of consistent guidance on medication safety, it can be difficult for the family physician to treat these conditions while encouraging mothers to continue breastfeeding. The purpose of the current review is to summarize and clarify treatment options for the osteopathic family physician treating lactating mothers. We specifically focus on the pharmacological management of contraception, postpartum depression, and lactational mastitis.


2012 ◽  
Vol 04 (01) ◽  
pp. 47-49 ◽  
Author(s):  
Tanawat Teerasahakoon ◽  
Mayura Boonthathip ◽  
Chirotchana Suchato

Sign in / Sign up

Export Citation Format

Share Document