"The Importance of Adding Fenestration to Ultrasound-Guided Baker's Cyst Aspiration"

This study aims to evaluate whether adding a fenestration procedure to standard ultrasound-guided aspiration and corticosteroid-lidocaine injection provides additional clinical benefits for patients with symptomatic Baker's cyst associated with knee osteoarthritis. Baker's cyst is a fluid-filled swelling located behind the knee that may cause pain, stiffness, swelling, and limited mobility. Although aspiration with medication injection is commonly used to relieve symptoms, recurrence of the cyst is frequent. Fenestration is a minimally invasive technique in which small controlled openings are created in the cyst wall under ultrasound guidance to improve internal drainage and potentially reduce recurrence. In this prospective, randomized, double-blind, controlled study, participants will be assigned to one of two groups: 1. aspiration with corticosteroid and lidocaine injection, or 2. aspiration with corticosteroid and lidocaine injection plus fenestration. Pain, functional scores, cyst measurements, and recurrence will be assessed at follow-up visits at 2 weeks, 1 month, and 3 months. The purpose of this study is to determine whether the addition of fenestration results in better symptom improvement and lower rates of recurrence compared with standard aspiration alone.

Sex

All

Minimum age

40 Years

Maximum age

75 Years

Inclusion Criteria:

* Adults aged 40 to 75 years
* Diagnosis of knee osteoarthritis according to the 2010 American College of Rheumatology (ACR) criteria
* Presence of a symptomatic Baker's cyst confirmed by ultrasonography
* Ability to understand study procedures and provide written informed consent
* Sufficient intellectual and social capacity to comply with study visits and follow-up requirements

Exclusion Criteria:

* Presence of inflammatory arthritis, septic arthritis, crystal arthropathy, or secondary causes of knee osteoarthritis
* Kellgren-Lawrence grade 4 knee osteoarthritis
* Active systemic infection
* History of malignancy
* Intra-articular knee injection within the past 3 months
* Knee trauma within the past 3 months
* History of knee surgery
* Contraindications to aspiration or corticosteroid injection (e.g., local infection, bleeding disorders, uncontrolled diabetes mellitus)
* Requirement to continue medications for inflammatory arthritis
* Diagnosed psychiatric disorder that may impair study participation
* Use of nonsteroidal anti-inflammatory drugs (NSAIDs) within the past 1 week
* Physical therapy applied to the knee region within the past 1 month

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