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Ruptured Popliteal Cysts Mimicking Deep Vein Thrombosis in Well-Functioning Total Knee Replacements: Report of Two Cases and Review of Literature

BACKGROUND: Implant wear and loosening with eluding metal/polythene debris are commonly implicated in the occurrence of Baker’s cysts in post-operative total knee replacement (TKR) patients, who present with post-operative pain and swelling, mimicking deep venous thrombosis. However, we present two...

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Autores principales: Dhillon, Mandeep S., Vatsya, Pulak, Dhatt, Sarvdeep S., Kumar, Vishal, Kumar, Prasoon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Indian Orthopaedic Research Group 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8422003/
https://www.ncbi.nlm.nih.gov/pubmed/34557432
http://dx.doi.org/10.13107/jocr.2021.v11.i05.2188
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author Dhillon, Mandeep S.
Vatsya, Pulak
Dhatt, Sarvdeep S.
Kumar, Vishal
Kumar, Prasoon
author_facet Dhillon, Mandeep S.
Vatsya, Pulak
Dhatt, Sarvdeep S.
Kumar, Vishal
Kumar, Prasoon
author_sort Dhillon, Mandeep S.
collection PubMed
description BACKGROUND: Implant wear and loosening with eluding metal/polythene debris are commonly implicated in the occurrence of Baker’s cysts in post-operative total knee replacement (TKR) patients, who present with post-operative pain and swelling, mimicking deep venous thrombosis. However, we present two symptomatic cases presenting with ruptured Baker’s cysts post-TKRs, with no evidence of implant loosening or wear. CASES REPORT: The 1st patient was a 55-year-old male, who underwent TKR for Grade 4 bilateral knee osteoarthritis and presented with acute onset of pain and swelling over the left popliteal fossa, which progressed to involve the calf. Radiographs showed no sign of infection or loosening, and venous color Doppler and magnetic resonance imaging (MRI) showed a hy-poechoic collection in the intermuscular plane at the upper part of popliteal fossa. Histological examination of the aspirated fluid showed mixed features of cystic fluid and a resolving hematoma. There was complete resolution of the 4 months with rest and graduated physiotherapy. The 2nd patient was a 51-year-old female who developed the cystic swelling 2 years after the surgery, and the ultrasound showed hypoechoic echoes in a Baker’s cyst-like collection. Cytological findings were suggestive of hemorrhagic nature of the aspirate, without any evi-dence of polyethylene debris, and the cultures were sterile. She became asymptomatic over 4 weeks with conservative management; the swelling resolved after 3 months. CONCLUSION: Majority of the cases in literature show implant loosening as cause of popliteal cysts after TKRs, however present cases highlight alternative mechanisms, and there are good chances of self-resolution of cysts with conservative treatment in such cases.
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spelling pubmed-84220032021-09-22 Ruptured Popliteal Cysts Mimicking Deep Vein Thrombosis in Well-Functioning Total Knee Replacements: Report of Two Cases and Review of Literature Dhillon, Mandeep S. Vatsya, Pulak Dhatt, Sarvdeep S. Kumar, Vishal Kumar, Prasoon J Orthop Case Rep Case Report BACKGROUND: Implant wear and loosening with eluding metal/polythene debris are commonly implicated in the occurrence of Baker’s cysts in post-operative total knee replacement (TKR) patients, who present with post-operative pain and swelling, mimicking deep venous thrombosis. However, we present two symptomatic cases presenting with ruptured Baker’s cysts post-TKRs, with no evidence of implant loosening or wear. CASES REPORT: The 1st patient was a 55-year-old male, who underwent TKR for Grade 4 bilateral knee osteoarthritis and presented with acute onset of pain and swelling over the left popliteal fossa, which progressed to involve the calf. Radiographs showed no sign of infection or loosening, and venous color Doppler and magnetic resonance imaging (MRI) showed a hy-poechoic collection in the intermuscular plane at the upper part of popliteal fossa. Histological examination of the aspirated fluid showed mixed features of cystic fluid and a resolving hematoma. There was complete resolution of the 4 months with rest and graduated physiotherapy. The 2nd patient was a 51-year-old female who developed the cystic swelling 2 years after the surgery, and the ultrasound showed hypoechoic echoes in a Baker’s cyst-like collection. Cytological findings were suggestive of hemorrhagic nature of the aspirate, without any evi-dence of polyethylene debris, and the cultures were sterile. She became asymptomatic over 4 weeks with conservative management; the swelling resolved after 3 months. CONCLUSION: Majority of the cases in literature show implant loosening as cause of popliteal cysts after TKRs, however present cases highlight alternative mechanisms, and there are good chances of self-resolution of cysts with conservative treatment in such cases. Indian Orthopaedic Research Group 2021-05 /pmc/articles/PMC8422003/ /pubmed/34557432 http://dx.doi.org/10.13107/jocr.2021.v11.i05.2188 Text en Copyright: © Indian Orthopaedic Research Group https://creativecommons.org/licenses/by-nc-sa/3.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Dhillon, Mandeep S.
Vatsya, Pulak
Dhatt, Sarvdeep S.
Kumar, Vishal
Kumar, Prasoon
Ruptured Popliteal Cysts Mimicking Deep Vein Thrombosis in Well-Functioning Total Knee Replacements: Report of Two Cases and Review of Literature
title Ruptured Popliteal Cysts Mimicking Deep Vein Thrombosis in Well-Functioning Total Knee Replacements: Report of Two Cases and Review of Literature
title_full Ruptured Popliteal Cysts Mimicking Deep Vein Thrombosis in Well-Functioning Total Knee Replacements: Report of Two Cases and Review of Literature
title_fullStr Ruptured Popliteal Cysts Mimicking Deep Vein Thrombosis in Well-Functioning Total Knee Replacements: Report of Two Cases and Review of Literature
title_full_unstemmed Ruptured Popliteal Cysts Mimicking Deep Vein Thrombosis in Well-Functioning Total Knee Replacements: Report of Two Cases and Review of Literature
title_short Ruptured Popliteal Cysts Mimicking Deep Vein Thrombosis in Well-Functioning Total Knee Replacements: Report of Two Cases and Review of Literature
title_sort ruptured popliteal cysts mimicking deep vein thrombosis in well-functioning total knee replacements: report of two cases and review of literature
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8422003/
https://www.ncbi.nlm.nih.gov/pubmed/34557432
http://dx.doi.org/10.13107/jocr.2021.v11.i05.2188
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