Abstract
We report a 65-year-old man who presented with a necrotic fifth toe, incipient phlegmon
and hypesthesia of the right foot, a swollen lower leg, and a palpable popliteal mass.
An occlusion of the popliteal artery secondary to a Baker's cyst was found to have
caused protracted ischemia and the abovementioned symptoms. Despite several endovascular
and open-surgery procedures to restore perfusion of the limb, the patient eventually
had to undergo above-knee amputation.
It might be speculated whether earlier surgery would have preserved the patient's
limb. Whereas the traditional procedure of open resection of the Baker's cyst has
been associated with high recurrence rates, the condition can be treated effectively
and safely today by means of arthroscopic surgery. We believe that arthroscopic interventions
should at least be performed in the following instances: (1) in patients with recurrent
symptoms of a Baker's cyst after previous treatment of the intra-articular pathology
and previous aspiration of the cyst and (2) in patients with incipient sequelae that
indicate relevant compression of neurovascular structures of the popliteal fossa (pseudothrombophlebitis,
intermittent claudication, neuropathy).
Keywords
Baker's cyst - popliteal cyst - popliteal artery compression - knee arthroscopy -
above-knee amputation
