Catheter-based bipolar thermal ablation (RFITT) of the Baker cyst is a procedure currently in clinical use for endocystic minimally invasive thermal ablation of knee joint cysts. It was first introduced into clinical practice worldwide in 2009 by Saphenion® (Dr. Zierau in Rostock).
In the treatment of Baker’s cysts, the first step is usually treatment by means of punctures. Surgical procedures in which the Baker’s cyst is removed via a relatively long incision in the hollow of the knee are also performed if necessary. Due to the size of this surgical wound, significant postoperative complications are to be expected.
Catheter-supported bipolar thermal ablation (RFITT) was developed to circumvent this surgical treatment approach.
To make the treatment method as comfortable as possible for the patient, a local anesthetic is injected at the beginning. After insertion of the guide wire and the electrodes, a high-frequency alternating current flows through the cyst wall, which acts as an electrical conductor, due to the bipolar arrangement of the electrodes. This creates a thermal effect and tissue shrinkage (microwave effect).
Baker’s cysts are always the result of severe knee joint injuries or changes to the knee joint. Regardless of the treatment method, the risk of cysts returning remains very high if the knee joint itself is not treated. We therefore strongly recommend targeted diagnostics and parallel therapy of the knee joint changes before or after RFITT therapy of the Baker cyst.
In the case of Baker’s cyst therapy, the catheter therapies mentioned are “off label” use.
The procedure has been offered at the ROC Aschheim orthopaedic practice since summer 2023 and is constantly being developed further.
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