Surgical and Patient-Centered Outcomes of Open versus Arthroscopic Ganglion Cyst Excision: A Systematic Review

Abstract

Introduction As the popularity of wrist arthroscopy grows, it continues to prove useful in the treatment of ganglion cysts. Previous studies comparing an arthroscopic technique to traditional open excision have demonstrated generally equivalent results regarding complications and cyst recurrence. However, this systematic review compares the two treatment methods not only regarding cyst recurrence but also regarding patient-centered outcomes. Additionally, new studies in the available literature may allow for further analysis. Methods This systematic review identified 23 articles published between 2000 and 2021 that met inclusion criteria. Articles were assessed for quality, and reported cyst recurrence rates, patient satisfaction, patients' preoperative and postoperative pain, and complications associated with either open or arthroscopic excisions were pooled into open excision and arthroscopic excision groups for analysis. Results In total, 23 studies accounted for 1,670 cases. Pooled data for patient-centered outcomes indicated a significantly higher patient satisfaction rate (89.2 vs 85.6%, p < 0.001) and higher reported pain relief (69.5 vs. 66.7%, p = 0.011) associated with arthroscopic excision versus open excision. Recurrence rates were also significantly lower for the arthroscopic excision group (9.4 vs. 11.2%, p < 0.001). Overall, the complication rate was significantly lower for arthroscopic excision (7.5 vs. 10.7%, p < 0.001), but the complication profile distinctly differed between the two methods. Conclusions Both arthroscopic and open excision of dorsal wrist ganglions are viable treatment options. However, the results of this meta-analysis suggest benefits associated with the arthroscopic technique in both patient-centered outcomes and in traditional, surgical outcomes. This may prove advantageous as wrist arthroscopy becomes more common.

A Modified Approach for Arthroscopic Excision of Dorsal Midcarpal Ganglion Cysts Using Radiocarpal Portals

“…Arthroscopic management of dorsal ganglion cysts carries the risk of potential complications, such as tendon injuries, joint stiffness, hematoma, or paresthesia, which require caution. 1,5…”

“…Furthermore, compared with open excision, a recent systematic review has demonstrated a significantly lower complication rate and a higher patient satisfaction rate using arthroscopic management. 1 The traditional arthroscopic approach mainly focused on ganglion cyst resection in radiocarpal regions. 2 There was no consensus regarding the necessity of entering the midcarpal joint.…”

“…Although most of them are asymptomatic and might resolve spontaneously, surgical intervention may be necessary for patients who experience intolerable pain or are concerned about the esthetic appearance of their hands. Furthermore, compared with open excision, a recent systematic review has demonstrated a significantly lower complication rate and a higher patient satisfaction rate using arthroscopic management 1 …”