A Systematic Review of Complications and Recurrence Rate of Arthroscopic Resection of Volar Wrist Ganglion

Abstract

(1) level I-V evidence, (2) documentation of the number of wrists subjected to surgery, (3) documentation of surgical techniques used on wrists, and (4) documentation of surgical or post-surgical complications and recurrence rate of a volar wrist ganglion after arthroscopic resection. A complication was defined as an adverse outcome that was directly related to the operative procedure. Between 2001 and 2012, 13 articles met the inclusion criteria. Two articles were excluded and 11 were reviewed. A total of 232 wrists underwent arthroscopic surgery with 14 recurrences. The recurrence rate ranged from 0 to 20%, with mean of 6.03%. There were 16 (6.89%) complications. There was no connection with the ganglion in six wrists, three haematomas, three cases of neuropraxia of the dorsal radial nerve, two partial lesions of the median nerve, and two lesions of a branch of the radial artery. Patients did not have a decrease in the arc range of motion. Treatment of volar ganglia of the midcarpal joint was technically difficult and associated with a higher number of complications. In general, arthroscopic resection results in fewer complications and lower recurrence rates than an open surgical approach, but there is no clear evidence of such an advantage for arthroscopic resection of a volar wrist ganglion. Additional prospective, controlled clinical trials will be essential to address this important issue.

Patient-Related Outcomes of Arthroscopic Resection of Ganglion Cysts of the Wrist

“…This confirms the results from two systematic reviews that found recurrence following arthroscopic resection in 9% of 587 dorsal ganglion cysts and 6% of 232 volar ganglion cysts. 11,12 We reported a total of three complications in our patient group (6%), which is similar to complication rates described in other studies on arthroscopic ganglion cysts resection, although numbers vary widely (0-56%). 4,12 Noticeably, these rates are lower than those of open resection (4 vs. 14%), according to the meta-analyses by Head and colleagues.…”

“…11,12 We reported a total of three complications in our patient group (6%), which is similar to complication rates described in other studies on arthroscopic ganglion cysts resection, although numbers vary widely (0-56%). 4,12 Noticeably, these rates are lower than those of open resection (4 vs. 14%), according to the meta-analyses by Head and colleagues. 4 Similar to this study, complications in other studies include hematoma, infection, neuroma, painful scar tissue, and neuropraxia.…”

Incidence and anatomical distribution of hand tumours: a Singapore study

“…The method of excision may also lower recurrence rates: Head et al reported a 76% reduction in recurrence rate with open surgical resection compared to aspiration, (16) while arthroscopic resection for volar wrist ganglions was described to have a recurrence rate ranging from 0% to 20%. (17) The second most common benign tumour excised in our study was GCTTS, which is also referred to as pigmented villonodular tenosynovitis. Our study suggests that distal to the MCPJs, GCTTSs are more commonly excised than ganglions.…”

The Treatment of Wrist Ganglion Cyst by the Chinese Acupotomy and Crisscross Thread

“…Although surgical excision is the golden standard treatment for ganglion cysts, including open or arthroscopic surgical excision, its surgical trauma, postoperative complications (including unsightly scar) and high cost are the main reasons for patients to refuse surgery [6]. In addition, the recurrence rate of surgical excision varies from 3.8-42% [2,10]. So surgeons still attempt to nd a new treatment for ganglion cysts, with the advantages, including high success rate, low recurrence rate, low cost, safe and less surgery trauma.…”