Hygroma is a fairly common disease that occurs equally often in both adults and children. Most often affects the area of wrist and ankle. In second place is the knee joint, where the formation can be located both on the front surface and in the popliteal fossa.
The hygroma of the knee joint is a benign cystic formation that has a dense connective tissue membrane and viscous jelly-like contents. This hollow formation is anatomically connected with the joint's shell or the muscle tendon sheath, therefore it is located near the junction.
Young women are most often affected, but the prognosis is favorable. Education almost never degenerates into a malignant, but there is a relatively high risk of recurrence of the knee hygroma after its removal.
What is the hygroma and its causes
So, as we have already learned, the hygroma is a hollow formation, filled with viscous mucus. But how and why is it formed?
Previously it was believed that the knee hygiene is a common protrusion of the joint or tendon sheath with subsequent infringement of the isthmus and the formation of a tumor-like formation. But the results of recent studies prove that the nature of such a cyst is completely different.
For some reason, degenerative-dystrophic changes occur near the normal connective tissue of the joint or tendons near the normal connective tissue of the joint, and normal cells are susceptible to metaplastic processes. In this case, the first part of the altered cellular elements forms a capsule, and the second part begins to produce the contents of the cyst. This explains the frequent recurrence after surgical removal of the focus( if there is at least a part of the cells, then the cyst will grow again), as well as the inefficiency of conservative therapy.
Professional athletes with increased knee load have an increased risk of developing knee hygiene
The exact causes of cyst formation in the knee area are not known, but specialists, traumatologists and orthopedists identify several risk factors for the development of education:
- is a genetic predisposition( if any of therelatives had such an education, then a chance to get a similar is much higher);
- single knee injury;
- repeated frequent trauma of the knee joint;
- knee congestion associated with the characteristics of professional activities or with sports;
- in the past inflammatory knee diseases( arthritis, periarthritis, bursitis, etc.);
- the presence of chronic diseases of the musculoskeletal system( osteoarthritis, rheumatoid arthritis and others).
It is important to note that in most cases, hygromes appear in physically active people and athletes, so such people need to think about the health of their limbs and use during the exercises various knee joints that reliably fix and protect the articulation from overstrain.
Disease In 70% of cases, cystic lesions are located on the extensor surfaces of the joints, but can also be found on the flexor. At the same time, education data can cause considerable discomfort and inconvenience, as the amplitude of movements is limited and pain arises with permanent trauma of the sore spot.
The hygroma of the knee joint in children and adults develops gradually. First, in the area of the joint or near it, you can see a small swelling, which is clearly felt under the skin. Neoplasm can be a single, but often there are several nearby cysts. Gradually, education grows and can reach a few centimeters in diameter( 2-3).If the cyst is connected to the joint or tendon sheath, then for some time it may disappear, which creates the false impression that the disease has receded. But after a while( it may even be months and years) the hygroma appears again in the same place.
- round or oval formation up to 3-5 cm in size;
- surface is smooth;
- skin over the hygroma is not changed;
- consistency is soft, elastic and supple;
- formation is inactive, since it is fixed to the shell of the joint;
- does not hurt;
- is localized on the anterior surface of the joint or in the popliteal fossa;
- the skin over the formation is well shifted;
- has no symptoms of general malaise.
The hyposoma of the popliteal fossa occurs quite often. It has its own name - Baker's cyst. May be accompanied by discomfort during movement and pain.
Hypertis of popliteal fossa( cyst of Baker)
Pain sensations for hygroma are not characteristic, but if pressure is produced on the formation, it can hurt. In 35% of cases, the disease is completely asymptomatic. Also, the cyst may increase after active work, but at rest it decreases to its former size.
The hygroma can grow slowly enough for several years, or it may suddenly form. Independently cystic formations do not resolve and do not open. Never degenerate into malignant tumors, so the prognosis is favorable.
Diagnosis of the hygroma of the knee joint is not difficult. As a rule, there are enough clinical manifestations and anamnesis of the disease. To exclude the pathology of the bones, x-rays of the knee, MRI, CT, ultrasound and hygroma puncture are performed.
ultrasound makes it possible not only to visualize the hygroma, but also to study its structure, to evaluate the contents.
Differential diagnosis is performed with other benign tumorous diseases( lipomas, atheromas, chondromas), as well as with malignant neoplasms.
Hygroma puncture can be performed both for diagnostic and therapeutic purposes.
Treatment of hygroma of knee joint
Treatment of hygroma can be conservative and surgical.
Conservative methods include:
- Crushing and kneading of education. This is a very painful method in which, under the influence of an external force, the capsule of formation breaks and spreads its contents. The risk of recurrence is very high, since the entire capsule remains in place, in addition, the infection of the hygroma contents with its spreading into surrounding tissues may occur.
- Puncture of education. In this case, a thin needle is inserted into the cavity of the hygroma and its contents are sucked off using a syringe. Often the treatment is complemented by the introduction of enzymatic and sclerosing drugs into the interior, which contributes to the collapse of the cyst walls. The percentage of relapses after such manipulations is high, since the capsule remains in place.
- Also use various physiotherapy, shock wave therapy, laser therapy, mud bandages, compresses with various ointments. The effectiveness of such treatment is questionable.
To date, the only effective and radical method of treatment is surgical removal of education. Relapse after surgery is 8-20% compared with 80-90% of conservative therapy.
Indications for surgery are:
- pain and discomfort when moving with the foot, especially if the hygroma is in the popliteal fossa;
- limiting the amplitude of limb movements due to formation;
- cosmetic defect and patient desire;
- development of complications, for example, tumor compression of nerves and blood vessels;
- ineffectiveness of pre-conservative treatment;
- fast growth rates.
The operation can be performed on an outpatient basis under local anesthesia. After dissection of the skin and isolation of the pathological focus, it is excised, paying special attention to the base so as not to leave the slightest piece of tissue of formation, otherwise the hygroma can recur. After suturing the wound, a plaster bandage or a modern orthosis is applied to the knee.
Recently, a modern minimally invasive endoscopic technique for removing hygroma has been used. Advantages of such treatment is a small trauma, rapid recovery, excellent cosmetic result.
- What is the hygroma and its causes
- Diagnostic methods