Excision of synovial cyst of popliteal space (eg, Baker's cyst)
CPT4 code
Name of the Procedure:
Excision of Synovial Cyst of Popliteal Space (Baker's Cyst Excision)
Summary
Excision of a Baker's cyst, also known as a synovial cyst of the popliteal space, is a surgical procedure to remove a fluid-filled sac that forms behind the knee. This cyst can cause pain, swelling, and restricted movement.
Purpose
The procedure addresses the presence of a Baker's cyst that may result in pain, swelling, and difficulty moving the knee. The goal is to alleviate these symptoms and prevent recurrence.
Indications
- Persistent pain or discomfort in the knee
- Swelling behind the knee
- Restricted range of motion
- Failure of non-surgical treatments such as medication, physical therapy, or fluid aspiration
Preparation
- Fasting for 8-12 hours before surgery
- Stopping certain medications as instructed by the physician
- Diagnostic tests such as MRI or ultrasound to confirm the cyst and its size
Procedure Description
- The patient is given regional or general anesthesia to ensure comfort.
- An incision is made behind the knee to access the cyst.
- The cyst is carefully excised, ensuring minimal disruption to surrounding tissues.
- The incision is closed with sutures, and a sterile bandage is applied.
The procedure typically involves surgical tools like a scalpel, forceps, and possibly arthroscopic instruments.
Duration
The procedure usually takes around 45 minutes to 1 hour.
Setting
Performed in a hospital or an outpatient surgical center.
Personnel
- Orthopedic surgeon
- Anesthesiologist
- Surgical nurse
- Scrub technician
Risks and Complications
- Infection
- Bleeding
- Damage to surrounding structures (nerves, blood vessels)
- Recurrence of the cyst
- Deep vein thrombosis (DVT)
- Adverse reactions to anesthesia
Benefits
- Relief from pain and swelling
- Improved knee mobility
- Enhanced quality of life and daily function Benefits are often realized within a few weeks post-surgery, once initial healing occurs.
Recovery
- Pain management with prescribed medications
- Keeping the leg elevated to reduce swelling
- Use of crutches if necessary
- Physical therapy to regain motion and strength
- Follow-up appointments to monitor healing and remove sutures
- Full recovery typically takes several weeks
Alternatives
- Non-surgical treatments like aspiration of the cyst, physical therapy, corticosteroid injections
- While less invasive, these alternatives might provide temporary relief and have a higher chance of recurrence compared to surgical removal.
Patient Experience
During the procedure, the patient is under anesthesia and will not feel pain. Post-procedure, there might be some pain and swelling, managed with medications and ice packs. Most patients can return to normal activities within a few weeks, with some modifications based on the surgeon's advice.