Arthroscopic Dorsal Wrist Ganglion Excision with Color-Aided Visualization of the Stalk: Minimum 1-Year Follow-Up

Abstract

Background Dorsal wrist ganglia (DWG) are a common, benign soft-tissue mass of the wrist. Excision of DWG is a common procedure performed by hand surgeons and may be performed using either open or arthroscopic techniques. This study aims to evaluate the frequency of stalk visualization with intralesional injection of inert dye in the course of arthroscopic excision along with incidence of recurrence with a minimum of 1-year follow-up. Methods Upon IRB approval, a retrospective chart review was performed identifying 27 patients who had consecutively undergone arthroscopic excision of a DWG with the coloraided technique at our institution with a minimum follow-up duration of 12 months. Intraoperative findings were reviewed. Patients were contacted to investigate for incidence of recurrence. Results Of the 27-patient cohort, the ganglion stalk was identified in 100 % of the color-aided arthroscopic DWG excisions. Ganglion recurrence was identified in one patient, an incidence of 3.7 %. Conclusions The color-aided technique for arthroscopic DWG visualization was found to be a safe and valuable tool for surgeons performing arthroscopic DWG resection. The intraarticular ganglion stalk was identified in 100 % of cases and patients responded well with a low incidence of recurrence.

Arthroscopic Resection of Dorsal Wrist Ganglion: Results and Rate of Recurrence Over a Minimum Follow-up of 4 Years

“…7 Revision of literature shows different recurrence rates of 0% to 11%. 1,13,21,25,30,32,33 In our study, we found recurrence in 1 patient (29%), 3 months following arthroscopic treatment; the patient refused further surgical treatment because he was asymptomatic. We believe that two factors are possibly responsible for the recent excellent success rates of arthroscopic resection of dorsal wrist ganglion: further dissemination of technical knowledge about wrist arthroscopy, and a skill progression of most surgeons in the natural learning curve of the wrist arthroscopy technique.…”

Arthroscopic resection of wrist ganglia: About 30 cases

“…Sometimes, the simple puncture of the ganglion made it possible to verify its position by regression of an intra-articular bulge. Other authors, such as Dumontier et al 6 or Ahsan and Yao, 7 injected methylene blue into the ganglion, and the localization was confirmed when the blue spread throughout the joint. Osterman and Raphael 8 and Mathoulin preferred to locate the ganglion using needles introduced in a trans-cystic manner.…”

Ressecção artroscópica do cisto sinovial volar do punho: Técnica cirúrgica e série de casos

“…One of the authors of the present study uses the technique proposed by Yao and Trindade 13 to facilitate the location of the cyst pedicle. 14 Prior to arthroscopy, the cyst is infiltrated with 2 mL or 3 mL of methylene blue. As such, the whole cyst is tinted by the dye, and intra-articular visualization is made easier.…”

“…Um dos autores do presente estudo utiliza a técnica proposta por Yao e Trindade 13 para facilitar a localização do pedículo do cisto. 14 Nela, previamente à artroscopia, infiltra-se o cisto com 2 mL ou 3 mL de azul de metileno. Isso fará com que todo o cisto fique tingido pelo corante, facilitando a visualização intra-articular.…”