Prolotherapy for Baker’s Cyst

David N. Woznica, MD 

When you have instability of the knee, the knee compensates in many ways to keep itself functioning. One way the knee tries to stabilize itself is with the collection of fluid. The fluid acts as a brace to keep everything in place as best it can. In the case of a Baker’s cyst, the accumulation of fluid occurs in a sac behind the knee, causing discomfort and difficulty bending the knee.

If you have questions about Baker’s Cyst treatment options, get help and information from our Caring Medical staff

Often, patients get these cysts drained only to have them fill right back up again. Why does that happen? Draining a cyst does not address the joint instability that caused the cyst to form in the first place. Neither does surgery.

The surgical treatment of Baker’s or Popliteal synovial cysts remains controversial

The surgical treatment of Baker’s or Popliteal synovial cysts remains controversial. The reason is high failure rate and further controversy over the long-term consequence of arthroscopic knee procedures.

The controversial treatment of a persisting Baker’s cyst involves draining the cyst, usually repeatedly, and/or surgery to remove the cyst and surgically repair any damage to the surrounding tissue including meniscus tears.

Turkish researchers reported in their study that it is now well-established that formation of Baker cysts is associated with intra-articular pathologies (knee damage and degeneration) of the knee, and in particular with medial meniscus tears or other conditions that cause general effusion (swelling) of the knee.1

Again, the problem with cyst draining and surgery is that both of these approaches do not address the root cause of the condition properly – that is knee instability. Further, surgery involving any joint, and especially the knee, is very invasive and prone to post surgical problems.

Doctors reporting in the medical journal Sports Health wrote: “Surgical excision (removal) of the Baker’s cyst without treatment of any intra-articular lesions (tears and other damage) has been reported; however, the results have been disappointing because of the high rate of recurrence. . . The high rate of recurrence is believed to be a result of the continued presence of intra-articular pathology and associated recurrent effusions.”2

  • In simple terms, the damage in the knee that is causing the swelling needs to be fixed in order to fet rid of a Baker’s Cyst. If nothing gets fixed, the problem persists.

Baker’s Cysts Remain After Total Knee Replacement

Doctors in Germany tested the widely held belief that recurring Baker’s cyst will be cured after total knee replacement. Here are the surprising results:

  • After one year, a Baker’s cyst was still present in 85% of patient’s tested.
  • Despite a reduction in associated Baker’s cyst related symptoms from before surgery  (71%) to after surgery (31%). Of the patients who had reported Baker’s cyst associated symptoms pre-operatively, (44%) still complained of such symptoms one year after surgery.

Baker’s cysts had resolved in only a small number of patients (15%) one year after total knee replacement and symptoms from the cysts persisted in 31%. 

Non-Surgical Prolotherapy for Baker’s Cysts

Doctors in Turkey presented a case history in which they suggested Prolotherapy, specifically dextrose Prolotherapy injections diminished the size of the baker’s cyst knee by changing the “water pressure on the knee.”

Why the dextrose? Because the dextrose had an impact of the amount of glucose in the knee. Glucose in correct amounts is necessary for wound healing. Too much glucose as seen in diabetes results in healing problems. The dextrose had a regulatory effect and created a “hypertonic” situation, that is it added to the water pressure levels of the cyst innards. Because of the added pressure, the liquid began seeping out of the cyst and back into the knee joint where regular immune system functions could remove the fluid.

The Prolotherapy injections squeezed out the baker’s cyst

Address the instability by receiving Prolotherapy to tighten the loose ligaments and the joint will stop swelling! We have excellent results using Prolotherapy to help patients with Baker’s cysts resolve the pain and keep the cyst from returning!

Prolotherapy, stimulated the injured tissue, whether it’s the ligaments or the meniscus, to repair itself. Once repaired, the knee joint becomes more stable, which means no more joint swelling. This in turn means no more accumulated fluid and an end to the baker’s cyst!

If you have questions about Baker’s Cyst treatment options, get help and information from our Caring Medical staff

1 Saylik M, Gökkuş K. Treatment of baker cyst, by using open posterior cystectomy and supine arthroscopy on recalcitrant cases (103 knees). BMC Musculoskeletal Disorders. 2016;17:435. doi:10.1186/s12891-016-1291-5. [Pubmed]

2 Yavuz F, Kibar S, Balaban B. Hypertonic Dextrose Injection for The Treatment of a Baker’s Cyst. Journal of Clinical and Diagnostic Research : JCDR. 2016;10(2):YD01-YD02. [Pubmed]

3 Frush TJ, Noyes FR. Baker’s Cyst: Diagnostic and Surgical Considerations. Sports Health. 2015;7(4):359-365. doi:10.1177/1941738113520130. [Pubmed]

4 Hommel H, Perka C, Kopf S. The fate of Baker’s cyst after total knee arthroplasty. Bone Joint J. 2016 Sep;98-B(9):1185-8. [Pubmed]