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.
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
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