"The Importance of Adding Fenestration to Ultrasound-Guided Baker's Cyst Aspiration"
Summary
This study aims to evaluate whether adding a fenestration procedure to standard ultrasound-guided aspiration and corticosteroid-lidocaine injection provides additional clinical benefits for patients with symptomatic Baker's cyst associated with knee osteoarthritis. Baker's cyst is a fluid-filled swelling located behind the knee that may cause pain, stiffness, swelling, and limited mobility. Although aspiration with medication injection is commonly used to relieve symptoms, recurrence of the cyst is frequent. Fenestration is a minimally invasive technique in which small controlled openings are created in the cyst wall under ultrasound guidance to improve internal drainage and potentially reduce recurrence. In this prospective, randomized, double-blind, controlled study, participants will be assigned to one of two groups: 1. aspiration with corticosteroid and lidocaine injection, or 2. aspiration with corticosteroid and lidocaine injection plus fenestration. Pain, functional scores, cyst measurements, and recurrence will be assessed at follow-up visits at 2 weeks, 1 month, and 3 months. The purpose of this study is to determine whether the addition of fenestration results in better symptom improvement and lower rates of recurrence compared with standard aspiration alone.
Timeline
- Start
- 2026-02-15
- Primary completion
- 2026-05-30
- Completion
- 2026-05-30
Publications
- Background Kim JM, Kang S, Yoon JS. Association of complicated Baker's cysts with knee pathologies as compared to simple Baker's cysts. Medicine (Baltimore). 2024 Jun 7;103(23):e38407. doi: 10.1097/MD.0000000000038407.
- Background Mortada M, Amer YA, Zaghlol RS. Efficacy and Safety of Musculoskeletal Ultrasound Guided Aspiration and Intra-Lesional Corticosteroids Injection of Ruptured Baker's Cyst: A Retrospective Observational Study. Clin Med Insights Arthritis Musculoskelet Disord. 2020 Nov 10;13:1179544120967383. doi: 10.1177/1179544120967383. eCollection 2020.
- Background Collins NJ, Misra D, Felson DT, Crossley KM, Roos EM. Measures of knee function: International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, Knee Injury and Osteoarthritis Outcome Score (KOOS), Knee Injury and Osteoarthritis Outcome Score Physical Function Short Form (KOOS-PS), Knee Outcome Survey Activities of Daily Living Scale (KOS-ADL), Lysholm Knee Scoring Scale, Oxford Knee Score (OKS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Activity Rating Scale (ARS), and Tegner Activity Score (TAS). Arthritis Care Res (Hoboken). 2011 Nov;63 Suppl 11(0 11):S208-28. doi: 10.1002/acr.20632. No abstract available.
- Background Ferdousi A, Islam MA, Begum M, Debnath MR, Shapla SP, Saha T, Biswas R, Ferdouse F, Rahman MA. Diagnostic Value of Ultrasonography in Determination of Knee Joint Pathologies with Comparison to MRI. Mymensingh Med J. 2024 Oct;33(4):989-995.
- Background Bandinelli F, Fedi R, Generini S, Porta F, Candelieri A, Mannoni A, Innocenti M, Matucci Cerinic M. Longitudinal ultrasound and clinical follow-up of Baker's cysts injection with steroids in knee osteoarthritis. Clin Rheumatol. 2012 Apr;31(4):727-31. doi: 10.1007/s10067-011-1909-9. Epub 2011 Dec 27.
- Background Chen CK, Lew HL, Liao RI. Ultrasound-guided diagnosis and aspiration of Baker's cyst. Am J Phys Med Rehabil. 2012 Nov;91(11):1002-4. doi: 10.1097/PHM.0b013e318269d95b. No abstract available.
- Background Oo WM, Linklater JM, Bennell KL, Pryke D, Yu S, Fu K, Wang X, Duong V, Hunter DJ. Are OMERACT Knee Osteoarthritis Ultrasound Scores Associated With Pain Severity, Other Symptoms, and Radiographic and Magnetic Resonance Imaging Findings? J Rheumatol. 2021 Feb;48(2):270-278. doi: 10.3899/jrheum.191291. Epub 2020 May 15.
- Background Acebes JC, Sanchez-Pernaute O, Diaz-Oca A, Herrero-Beaumont G. Ultrasonographic assessment of Baker's cysts after intra-articular corticosteroid injection in knee osteoarthritis. J Clin Ultrasound. 2006 Mar-Apr;34(3):113-7. doi: 10.1002/jcu.20210.
- Background Smith MK, Lesniak B, Baraga MG, Kaplan L, Jose J. Treatment of Popliteal (Baker) Cysts With Ultrasound-Guided Aspiration, Fenestration, and Injection: Long-term Follow-up. Sports Health. 2015 Sep-Oct;7(5):409-14. doi: 10.1177/1941738115585520. Epub 2015 May 5.
- Background Abate M, Di Carlo L, Di Iorio A, Salini V. Baker's Cyst with Knee Osteoarthritis: Clinical and Therapeutic Implications. Med Princ Pract. 2021;30(6):585-591. doi: 10.1159/000518792. Epub 2021 Aug 2.
Drugs
| Evaluation | Drug | Modality | Dose | Route |
|---|---|---|---|---|
| Background | Betamethasone | Other / unclassified | 1 ml | — |
| Background | Lidocaine | Other / unclassified | 1 ml | — |
| Background | sodium chloride | Unknown | 1 ml | — |