[Arthroscopic procedure for Baker's cysts : surgical technique. Video article].

BACKGROUND

Baker's cysts are related to increased intra-articular pressure. The causes may be inflammatory, degenerative or traumatic disorders. Owing to the increased intra-articular pressure a cyst protrudes between the semimembranosus and the medial gastrocnemius tendons. The traditional treatment for a Baker's cyst is open resection. As an alternative, an arthroscopic procedure can be performed, which is demonstrated by the video on surgical technique that accompanies this short report.

SURGICAL TECHNIQUE: From the anterolateral portal the arthroscope is advanced through the intercondylar notch (below the posterior cruciate ligament) to the posteromedial recess. Under visual control, a posteromedial portal is created followed by identification of the capsular fold separating the cyst from the joint cavity. This fold (valvular mechanism) is resected with a shaver from the posteromedial portal until a large enough connection exists between the joint and the cyst (cyst decompression). After the decompression, the arthroscope is inserted from the posteromedial portal directly into the cyst cavity. Subsequently, the inner wall of the cyst is removed with the shaver via an additional far posterior cystic portal. It is obligatory to treat the associated intra-articular pathological condition. In our video a medial meniscal lesion is treated with partial meniscectomy.