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Popliteal Cysts: Historical Background and Current Knowledge

Department of Orthopaedic Surgery, Bowman Gray School of Medicine, Winston-Salem, NC.

Popliteal cysts were first described in 1840 by Adams, but it is from Baker's writing in 1877 that we derive the commonly used eponymic term "Baker's cyst." Associated intra-articular lesions are very common with popliteal cysts. Ultra-sonography, arthrography, and magnetic resonance imaging have all proved useful in distinguishing popliteal cysts from other cysts and from soft-tissue tumors about the knee, as well as in identifying coexisting intra-articular lesions. Cysts in pediatric patients are generally self-limited and should be treated conservatively. In the adult population, treatment is primarily nonsurgical. Arthroscopic evaluation is indicated if an intra-articular lesion is causing mechanical symptoms or if there is no response to appropriate conservative treatment, such as use of nonsteroidal anti-inflammatory drugs and compression sleeves. Surgical excision is reserved for cases in which this approach has been unsuccessful.