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Preparing for Aspiration

Although aspiration is generally a low-risk procedure, the decisions you make and the actions you take before your aspiration can be as important as the procedure itself in ensuring a healthy recovery. Most insurance companies require a second opinion before agreeing to reimburse a patient for an aspiration procedure. Getting a second opinion from a physician who is as qualified as the physician who gave the initial diagnosis is advisable in any case. Understand the potential risks and benefits of aspiration, and ask your physician any questions that will help you better understand the procedure. It can also help to talk to someone else who has undergone the same procedure. Any physical problems, such as a fever or infection, should be reported to your physician, and you should notify your physician of any medication you are taking. You will probably not need any anaesthetic and should not have restrictions placed on food or drink in the days preceding aspiration.

Here are some important steps to remember as you prepare to go to the hospital or outpatient clinic for an aspiration of your baker's cyst:

   At most medical centers, you will go to "patient admissions" to check in for your aspiration procedure. Aspiration is usually an outpatient procedure but there may be a separate department for inpatient surgery, so be sure to ask your doctor.

   After you have checked in to the hospital or clinic for your aspiration, you will go to a holding area where the final preparations are made. Paperwork regarding your past medical history and medication allergies is completed. You will change into a hospital gown, and remove all of your jewelry.

   You may be given a narcotic painkiller or a sedative, so you should arrange ahead of time for someone to help you leave the hospital and drive you home.

   Wear a loose pair of pants or other clothing that will fit comfortably over your knee bandage when you leave the hospital.

Most aspirations for baker's cysts take about 15 minutes to perform. You are usually given a local anesthetic that numbs your lower leg.

   Your physician will insert a needle into the center of the Baker's cyst.

   The thick, transparent joint fluid is slowly removed.

   Depending on the size of your cyst, the physician may have to insert the needle and draw fluid multiple times.

   When all the fluid has been removed, your cyst will generally no longer be visible.

   Your knee is wrapped with a compressive dressing that helps stop tissues from expanding and collects any minor drainage that may occur. Stitches are not needed.

After an aspiration, your knee may look and feel as if it has been deflated. Patients do not generally need to go to the recovery room after an aspiration. You will be taken to the waiting room or another quiet area in the doctor's office or hospital. When the local anesthetic wears off, in about one to two hours, you will be able to leave. Your physician and a nurse usually talk to you and explain that there is a chance of the cyst recurring. Depending on the cause of your cyst, you will be given instructions on what to do to properly heal your knee. Physicians generally recommend that you have someone waiting to drive you home.

Here is what you can expect and how you can cope after aspiration of a baker's cyst:

   Physicians generally suggest that you rest at home with your knee elevated for about 24 hours.

   You will probably feel moderate pain, but it usually goes away within 24 hours and you may be able to resume moderate activities the next day.

   You can usually remove the bandage the day after aspiration. Most people do not experience much bleeding or fluid drainage.

   As much as possible, you should keep your knee elevated above heart level to reduce swelling and pain. It often helps to sleep with pillows under your ankle.

   Consider placing a heating pad or warm towel on the back of knee to ease any pain or discomfort from the needle incision.

   You can typically bathe and swim without restriction, but be sure you can comfortably stand up for ten to 15 minutes at a time before showering.

   Feel free to use non-prescription painkillers, like aspirin or ibuprofen, as directed on the bottle for any pain you feel.

   As soon as possible after surgery, you should begin doing physical therapy as directed by your surgeon.

   Return to normal daily activities as soon as possible. You may return to work the same day after aspiration, depending on the severity of your pain. Most patients return to work within three to five days.

The underlying cause of your Baker's cyst, whether it was arthritis, torn cartilage, or other knee problems, usually dictates the specific rehab program you need to undergo. Your physician may prescribe visits to a physical therapist to begin supervised strengthening exercises as soon as possible after aspiration of your baker's cyst. After aspiration, you usually need to avoid strenuous activities that put pressure on the bones in your knee. Running, jumping, or twisting may aggravate the synovial membrane and increase its production of fluid, causing your cyst to swell again. You can begin therapy immediately after aspiration in most cases, depending on the overall condition of your knee. The rehab program to help heal your knee after a baker's cyst follows a general pattern. Most physical therapists suggest one to four weeks of relative rest. This means modifying your workouts to avoid activities that cause pain. You can also reduce the intensity of your workout - for example, Instead of riding a bike or running, you could swim or rollerblade, or reduce the intensity of your workout by using less resistance when you ride or by eliminating hills from a running workout. Physicians also suggest that you stretch and strengthen the muscles that support the knee to help take strain off the knee bones. After about four weeks of rehab, physical therapy can become activity-oriented as you regain the ability to perform complicated movements, using stationary bikes, elliptical machines, and cross-country skiing machines. Physicians usually suggest that you continue strength training even after your knee has been rehabilitated. Have your physician periodically check your knee for strength and signs of a recurring baker's cyst.

Aspiration usually provides immediate pain relief of baker's cyst, as the cyst is no longer getting in the way of knee movement. However, you probably will remain at risk for the cyst to recur. The best way to prevent a recurring baker's cyst is to properly treat the knee problem or disease that caused the cyst. In the absence of other knee complications, the amount of caution you should use during activities to prevent a baker's cyst from recurring depends on your age as follows:

   Children ­ a baker's cysts rarely affect joint function. Once cysts heal, they rarely return.

   Adults ­ the cyst may signal that you have sustained some degree of cartilage damage. Becoming less involved in strenuous activities, like contact sports or long distance running, may help prevent future baker's cysts. But you do not need to avoid activities or be overly concerned with prevention unless the underlying cause of your baker's cyst was a severe disease or injury that warrants extra prevention measures.

   Seniors ­ a baker's cyst may be more problematic later in life, harming the function of your knee joint, and you should continue to visit your physician for check-ups after the cyst heals. Because baker's cysts are common companions of rheumatoid arthritis and osteoarthritis, you should strongly consider cutting back your activity level to avoid situations that could strain your knee joint.

Weight control is also important. One extra pound of body weight translates into three or four pounds of weight across your knee every time you take a step. Lightening the load on your knees helps them to function better.

A baker's cyst usually goes away as the underlying joint injury or disease is treated. However, physicians can offer you immediate pain relief by extracting the fluid from your baker's cyst with a needle. This procedure, known as aspiration, is usually performed in conjunction with a knee arthroscopy, which lets physicians take a close look at your knee using a tiny camera.