Baker kisti ile beraber olan eklem içi lezyonlarının tedavi sonuçları

Giriş: Bu çalışmada diz içi patolojileri ile birlikte baker kisti (BK) olan 40 hastanın artroskopik cerrahi ve konservatif tedavi sonrasında baker kistlerinin akıbetleri araştırıldı. Hastalar ve Yöntem: Çalışmaya dahil edilen hastaların tümünde eklem içi patolojilerine eşlik eden BK mevcuttu. Hastaların 20'si kadın, 20'si erkek idi. Hastalardan 20'si artroskopik cerrahi ile tedavi edildi. Cerrahi uygulanan hasta grubunda ortalama yaş 45 (dağılımları; 23-61) idi. Hastalar son kontrollerinde MRG ile değerlendirilerek tedavi öncesi ile sonrası BK boyutlarındaki değişiklikler tespit edildi. Yirmi hasta konservatif tedavi ile takip edildi. Tedavi esnasında diz çevresini kuvvetlendirici egzersizler ve antinflamatuvar ilaçlar kullanıldı. Her iki tedavi grubundaki hastalar tedavi öncesi ve sonrasında Lysholm diz skoru ile değerlendirildi. Bulgular: Artroskopik cerrahi olarak tedavi edilen hastalardan 6 hastada kistlerine ait yakınmaları yoktu. Yapılan MRG kontrollerinde 4 hastada BK kaybolmuştu. Kistlerine ait yakınmaları süren 14 hastanın 8'inin MRG'lerinde, kistin boyutları incelendiğinde BK'leri aynı büyüklükteydi. 6 hastada ise bir miktar azalma mevcuttu. Bu hastalarda artroskopik tedavi öncesi Lysholm skoru ortalama 64 (dağılımları 54-74) idi. Son takiplerinde bu skor ortalama 78 (dağılımları 68-100) bulundu. Konservatif tedavi ile takip edilen hastalarda tedavi öncesi ortalama Lysholm diz skoru 62 iken (dağılımları 57-85), tedavi sonrasında bu skor ortalama 68 (dağılımları 52-100) oldu. Hastalardan 6'sında kiste ait yakınmaları yoktu. 3 hastada ise kist boyut olarak küçülmüştü. Tartışma: Literatürde de vurgulandığı üzere, BK'li eklem içi lezyonları olan hastaların uygun tedavi seçeneği artroskopik cerrahidir. Özellikle eklem içi lezyonların artroskopi ile kesin tedavi edildiği durumlarda sonuçlar daha başarılıdır.

Treatment result of intraarticular knee patologies associated with Baker's cyst

Introduction: The aim of the study was to investigate the natural histories of Baker's cysts (BC) in 40 patients whose associated intraarticular knee pathologies were treated by arthroscopic surgery or conservative methods. Patients and Methods: BC was present in all patients together with associated intraarticular pathologies. The half of the patients were male and half female. The arthroscopic surgery was performed in 20 patients. The mean age in this group was 45 (range; 23-61). With the help of MRI, the changes in the size of BC was determined preoperatively and postoperatively. Twenty patients received conservative treatment, knee muscles strenghtening exercises and antiinflammatory agents. The patients in both groups were evaluated pre and post treatment by using Lysholm knee scores. Results: Six patients in the arthroscopically treated group had no compliants related with their cysts. MRI showed the dissapperance of BC in 4 patients. The remaining 14 patients were stil complaining related with the BC and their MRI showed no change in the size of the cysts. The Lysholm knee scores in these patients were meanly 64 (range; 54-74) preoperatively and 78 (range; 68-100) postoperatively. The lysholm knee scores in conservatively treated patients were 62 (range; 57-85) before and 68 (range; 52-100) after treatment. Discussion: As in the literature, the treatment results of Baker cyst associated with intraarticular knee pathologies by performing arthroscopic surgery are better than those treated with conservative treatment.

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