Baker's cyst: literature data, clinical results of combined laser obliteration of large cysts

Baker's cyst (BС) is a common polyetiological disease characterized by the presence of a soft-elastic formation in the medial part of the popliteal fossa between the inner head of the calf and semipereminal muscles, which has a significant impact on the quality of life of patients. As literature shows, there is no consensus in the surgical treatment of BС, each method has its shortcomings, complications and risk of relapse. The use of laser technology allowed treatment in a minimally invasive and effective manner, but in large cysts direct laser exposure only to the walls of the mass was insufficient. Therefore, it became necessary to modify the method, namely, a combined direct laser treatment of both cyst walls and the junction Goal. Improve the results of treatment of patients with large-sized BС through the use and implementation of laser technologies in clinical practice. Materials and methods. The results of treatment of 11 patients with CB operated on from December 2019 to September 2020, aged 37 to 67 years. All patients underwent laser obliteration of the BС using the LSP-IRE-Polyus device, 1.56 μm wavelength 5VT in continuous mode under ultrasound control. The survey was conducted before the operation, 3 and 6 months after the operation using the following tools: VAS, Leken index, WOMAC and KOOS questionnaires. Results. The average age (M±s) was 55.18±9.06, average height - 177.91 ± 10.08 cm, average weight - 92 ± 12.79 kg, BMI - average 29.08 ± 3.28. Statistically significant improvement on the VAS, WOMAC, Leken, and KOOS scales was observed by 3 months of postoperative follow-up. The achieved results were preserved by 6 months after the operation. The pain intensity also decreased by 50% 3 months after the operation, and by 6 months it was close to the minimum value. When analyzing the results for the Leken index, an improvement in the “activity” indicator by 50% was achieved by 3 months after surgery, and by 6 months - by 90%, compared to the initial data. Conclusions. The results obtained suggest the possibility of introducing this technique into clinical practice with promising results. However, the work has drawbacks: a small sample and the absence of a long observation period. For more convincing conclusions and a reliable assessment of the effectiveness of the chosen method of surgical treatment of BС, it is necessary to continue working and analyze more results and long-term follow-up.