Arthroscopic Resection of Dorsal Wrist Ganglia and Treatment of Recurrences

Luchetti, Riccardo; Badía, Alejandro; Alfarano, M; Orbay, Jorge L.; Indriago, Igor; Mustapha, B.

doi:10.1054/jhsb.1999.0290

Cited by 96 publications

(77 citation statements)

References 5 publications

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“…Second, we analyzed only the measures at 2 years after surgery. Several studies have described data at various points of followup after 1 to 94 months after arthroscopic resection [7,11,12,16]. For comparison, we intended to analyze the measures at a single time: 2 years after surgery.…”

Section: Discussionmentioning

confidence: 99%

“…However, open resection can result in unsightly scars, dorsal sensory nerve injury, or wrist stiffness. Arthroscopic ganglion resection, initially reported by Osterman and Raphael [16], has become a common treatment and offers several theoretical advantages over open resection, including faster recovery, lower complication and recurrence rates, and more cosmetically superior incision scar [2,3,7,11,12,16]. We found similar improvement of outcome measures compared with previous studies on arthroscopic resection of dorsal wrist ganglions, including VAS pain score, grip strength, active flexion-extension arc, and MWS at 2 years after arthroscopic ganglion resection to their respective preoperative values (Table 3).…”

Section: Discussionmentioning

confidence: 99%

“…Accordingly, arthroscopic resection has been proposed as a potentially more favorable alternative to open resection, with recurrence rates of 0% to 11% [11,12,15,16] and improved pain, grip strength, and wrist motion [1,2,[7][8][9][10]. Further, arthroscopic resection reportedly is associated with no scaphoid subluxation or chronic scapholunate instability attributable to ligament injury during surgery that has been reported after open resection [2,3,8,11,12,16], and an improved cosmetic appearance [11]. Moreover, diagnostic arthroscopy together with ganglion resection simultaneously allows for thorough examination of the joint and treatment of coexisting intraarticular disorders commonly associated with symptomatic wrist ganglions, such as the triangular fibrocartilage complex (TFCC) or tears of intrinsic or extrinsic ligaments [3].…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, diagnostic arthroscopy together with ganglion resection simultaneously allows for thorough examination of the joint and treatment of coexisting intraarticular disorders commonly associated with symptomatic wrist ganglions, such as the triangular fibrocartilage complex (TFCC) or tears of intrinsic or extrinsic ligaments [3]. Nonetheless, persistent pain occurs in 0% to 17% of patients [8,11,12,15,16] and it is unclear whether coexisting intraarticular disorders influence persistent pain or recurrence after arthroscopic resection of dorsal wrist ganglions.…”

Section: Introductionmentioning

confidence: 99%

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Coexisting Intraarticular Disorders Are Unrelated To Outcomes After Arthroscopic Resection of Dorsal Wrist Ganglions

Kang¹,

Koh²,

Kim³

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background Dorsal wrist ganglions are one of the most frequently encountered problems of the wrist and often are associated with intraarticular disorders. However, it is unclear whether coexisting intraarticular disorders influence persistent pain or recurrence after arthroscopic resection of dorsal wrist ganglions. Questions/purposes We investigated (1) which intraarticular disorders coexist with dorsal wrist ganglions and (2) whether they influenced pain, function, and recurrence after arthroscopic ganglion resection. Methods We retrospectively reviewed 41 patients with primary dorsal wrist ganglions who underwent arthroscopic resection. We also obtained VAS pain scores and the Mayo Wrist Scores (MWS) preoperatively and at 2 weeks, 6 weeks, 3 months, 6 months, 1 year, and annually thereafter postoperatively. Minimum followup was 24 months (mean, 38.9 months; range, 24-60 months).Results Twenty-one patients had other coexisting intraarticular disorders: 18 triangular fibrocartilage complex tears and nine intrinsic ligament tears. All coexisting disorders were treated simultaneously. Two years after surgery, the mean VAS pain score decreased from 2.4 to 0.6, and mean grip strength increased from 28 to 36 kg of force. The mean active flexion-extension showed no change. The mean MWS improved from 74 to 91. Three ganglions recurred. There was no difference in mean VAS pain score and MWS preoperatively and at 2 years after surgery or recurrence of ganglions between patients with or without coexisting lesions. Conclusions Intraarticular disorders commonly coexist with ganglions but we found they were unrelated to pain, function, and recurrence after arthroscopic resection of the ganglion when the intraarticular disorders were treated simultaneously.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Coexisting Intraarticular Disorders Are Unrelated To Outcomes After Arthroscopic Resection of Dorsal Wrist Ganglions

Kang¹,

Koh²,

Kim³

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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“…The reported recurrence rate following arthroscopic resection ranges from zero to 7%. [11][12][13][14] This rate is still lower than that reported following open surgical excision. The main reason of recurrence is inability to identify the ganglion stalk.…”

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confidence: 99%

Arthroscopic resection of dorsal wrist ganglion

et al. 2016

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INTRODUCTIONGanglions are the most common causes of focal masses of the hand and wrist. They arise from the synovium of joints or tendon sheaths. Dorsal wrist ganglion is the most common type of ganglion arising from the hand.1 The exact etiology is not known and the most common site of origin is the dorsal scapho-lunate ligament. A one way valve is believed to exist which allows the fluid to enter the swelling from the joint and appear most commonly between the second and fourth extensor tendon compartment.2 The management of dorsal wrist ganglion ranges from benign neglect to open surgical excision. The key to open surgical excision is identification of the ganglion stalk and excision from the base.Open surgical excision is associated with morbidities like numbness around the scar, wrist stiffness, cosmetically unacceptable scar and a recurrence rate ranging from 10% to 40%. 2,3 Wrist arthroscopy has been an innovation in recent times with increasing application for managing wrist pathologies. Arthroscopic resection of dorsal wrist ganglion has advantages of a minimally invasive surgery, early return to function, a more cosmetically acceptable ABSTRACT Background: The management of dorsal wrist ganglion ranges from benign neglect to surgical excision. The purpose of this study was to study the results of arthroscopic resection of dorsal wrist ganglion. Methods: Twenty one patients who had undergone arthroscopic dorsal wrist ganglion excision and a minimum of 3 months follow up were included. The preoperative complaint of cosmesis, pain, and duration of swelling, wrist range of motion and size of the ganglion were noted. The duration the patient took to return to a painless wrist with full range of motion was noted. Patient satisfaction with respect to cosmesis and function was noted. Results: The mean age was 23.3 years (range: 13 to 35 years). Pre-operative wrist pain was present in 17 patients and cosmesis was a complaint in 18 patients. 5 patients had a pre-operative restricted range of motion. The mean duration and size of the ganglion was 2.6 months (range: 2 to 4 months) and1.8cm (range: 1 to 3 cm) respectively. The mean duration of follow up was 14.6 months (range: 3 to 24 months). Arthroscopically, dorsal synovitis was present in 10 patients, triangular-fibro-cartilage-complex (TFCC) tear in 2 patients and chondral damage in 1 patient. The ganglion stalk was visualized in 14 patients. Complete painless wrist range of motion was obtained by 20 patients by 3 weeks post-operative. One patient had a recurrence. All the remaining patients were satisfied cosmetically and functionally with the results. Conclusions: Arthroscopic resection is an effective treatment modality for symptomatic dorsal wrist ganglion with good functional and cosmetic results.

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