Q: My husband is a diabetic and has a Baker's cyst behind his left knee. He had an arthroscopic surgery for a torn meniscus. When the surgery was done the surgeon said that everything looks good but he was unable to find out what was causing the inflammation in the knee. We have given him cortisone shots as well but to no avail. He still has pain inside the knee. He can hardly walk despite physical therapy which was given after his surgery. What could be causing pain? He is a heart patient and he has poor circulation of blood in his legs with a stent, which is open and working fine in the main artery that supplies blood to his legs. Is the knee pain related to his diabetes? He's been on pain killers when necessary.

A:Diabetes always slows down the recovery process. This factor cannot be ruled out. So, take it easy. Proper care and treatment should help him. Basically, a Baker’s Cyst is an accumulation of joint fluid behind the knee. This condition can also be caused by a herniation of the knee joint capsule into the back of the knee. In some cases it is associated with a minor tear in the meniscal cartilage which is rare. A major factor of osteoarthritis is another associated cause of pain. Physiotherapy for knee mobility and strengthening exercises are a must. He can try ultrasound at a physiotherapy clinic. Avoid exercises with extreme flexion and extreme extension. You will have to do repeated small sessions of exercises for good results. After 2 weeks, you will be able to see the difference and then gradually he can do gait training. This should help him to walk better.