TKR Knee replacement for Bakers Cyst and Instability

[DeborahR]

Hello, I am a newbie here today...I am a 65 yo female with some arthritis and 2 bakers cysts above my knee bend areawhich causes a lit of pain. I am currently receiving a cortisone shot -one shot every 4 months, which only helps for 1 week to 2 weeks. The first time my OS drew 10 cc off and 2 months ago drew another 10 cc , he says it is a good color. I do some exercises on a stepper every morning and at night just doing some as it takes my mind off.
I get a lot of pain in my upper calf to mid calf area, I have instability at my knee when turning my foot and walking on uneven ground and downstairs).
My OS tells me only way to get rid of cysts is a knee replacement.
Wondering if you can direct me to which procedure will remove the Bakers cysts permantely and help restore better use of my leg and a better quality of life.

1. Arthroscopy
2. Knee Replacement

Thanks in advance
Deborah

 

[mendogal]

Welcome to BoneSmart, @DeborahR !

We can't definitively advise you as each person's anatomy and function is unique. In general the indications for knee replacement are bone on bone arthritis (because there is no way to reverse the process) and/or other issues creating severe joint instability.

So one question is, how severe is your arthritis? One of the links I'll provide on severity includes a measure called the Oxford scale - very helpful.

We have indeed had members whose Bakers cysts resolved once the other underlying issues were addressed by a total knee replacement.

Please do reply with any other questions or concerns!

KNEE PRE-OP GUIDELINES

If you are at the stage where you have joint pain but don't know for sure if you are ready to have surgery, these links may help:

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Score Chart: How bad is my arthritic knee?​

Choosing a surgeon and a prosthesis​

BMI Calculator - What to do if your surgeon says you're too heavy for joint replacement surgery​

Longevity of implants and revisions: How long will my new joint last?​

If you are at the stage where you are planning to have surgery but are looking for information so you can be better prepared for what is to come, take a look at these links:

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Recovery Aids: A comprehensive list for hospital and home​

Recliner Chairs: Things you need to know if buying one for your recovery​

Pre-Op Interviews: What's involved?​

Regardless of where you are in the process, the website and app My Knee Guide can help you stay organized and informed. The free service keeps all the information pertaining to your surgery and recovery in one place on your smartphone. It is intended to be a personal support tool for the entire process.

And if you want to picture what your life might be like with a replaced knee, take a look at some stories of amazing knee recoveries

 

[EalingGran]

I had a large Baker's cyst which has pretty much gone since my PKR. I also had a large supra patellar bursa and a pes anserine bursa which have disappeared too.
I don't think there is any way to remove Baker's cysts unless you have either a TKR or a PKR. Draining them is just temporary as the underlying cause remains. I tried exercises from a physio, such as bridges and stretching which were supposed to help- but they didn't really make any difference.
I agree with @mendogal that doing the Oxford knee score is a good idea. It will help you decide if you are ready for surgery.

 

[DeborahR]

Hi Mendogal and EalingGran, t Its been 2 years hanks for your replies, links and support.
I did the Oxford test last night and my score was 25.
My main concern is which procedure TKR OR PKR will permanently remove my Bakers cyst and lead to a faster recovery? It has been 2 years since my accident and I wanted to try all supports ie:-physio , cortisone and keep excercising ...but all is of little help. So I have made up my mind to have a replacement.
The incident that happened 2 years ago was doing yard work ... a 24"x24" cement patio stone I was bracing upright with my right knee slipped .
Thanks again all I will continue my research here and keep you posted.
My appointment with my OS is coming up -Feb 24 810am. for my shot which I will mention to him of my plan.
Deborah

 

[mendogal]

@DeborahR oh I'm sorry, your original query was arthroscopy vs replacement.
In terms of PKR vs TKR....
Some PKRs depending on which compartments are affected are rarely done and really require a specialist who does them regularly with good results.
Overall while some patients with PKRs (especially young athletes) do recover more quickly, it seems as if for the majority the healing and rehab time is similar to that of a TKR.

If you're seriously considering surgery and the shots don't last long, you might at your February appointment defer the shot in order to get on the surgery schedule more quickly. Most surgeons won't operate until the steroid is well out of your system due to the slight increase in infection risk.

 

[DeborahR]

Thanks Mendogal, Yes, I am seriously considering the surgery now as he says there is not the fluid build up so no more drawing off. which I feel it is time to do something .
I have to go to the hospital OS clinic...wait 2 hours to see him for my cortisone shot which is useless.
Thanks
Deborah

 

[EalingGran]

My main concern is which procedure TKR OR PKR will permanently remove my Bakers cyst and lead to a faster recovery?

Either a TKR or a PKR can remove a Baker's cyst but the decision depends on which compartments of your knee are affected. A PKR is only possible if just one compartment is affected by arthritis and the others are relatively OK.

 

[benne68]

I have to go to the hospital OS clinic...wait 2 hours to see him for my cortisone shot which is useless.

Be aware that most surgeons will require you to wait at least 3 months after a cortisone injection before doing a TKR because of concerns about infection.

So, if you are planning to go ahead with surgery, you might want to skip the next shot.

Do let us know what you decide about surgery.

 

[DeborahR]

Yes thank you all ..I agree with you and I will see what he suggests as
here, there is a backlog of patients waiting for hip and knee surgeries. I would like to get this done this spring ....but, probably won't happen.
I will let you know what happens on my Feb.24 appointment.

Deborah

 

[DeborahR]

Tha meds I am taking are Meloxicam and arthritis pain relief extended 650ml.

Meloxicam 1 a day
Pain relief 1 morning & 1 before bed

 

[mendogal]

Arthritis Pain Relief Extended 650 mg is acetaminophen.

If it's not very helpful, you might benefit from switching to Extra Strength Acetaminophen 500 mg tablets or capsules in order to get a more therapeutic dose.

The recommended dosage is TWO 500 mg tablets or capsules every 6 to 8 hours.

If you schedule it three times daily, that's 3,000 mg total per 24 hours, well within the 4,000 mg maximum safe dosage.

 

[EalingGran]

The anti-inflammatory I found most helpful was Naproxen. There is definitely some individual variations in response to different medication and side effects. So it is worth discussing with your GP and trying to find the one that suits you best.

 

[DeborahR]

Hi MendoGal, that is great info ... I am going to switch to that and cut the Meloxicam (which I only take 2 /3 mornings a week... I think it is affecting my BP.
Thank you

 

[DeborahR]

Hi EalingGran, thank you I tried Naproxen and it wasn't for me .. kept my nerves alive and agitated all night Trided it 2 nights but didn't sleel well.

Thanks